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At least 163 records · Page 9Linked to original sources
PubMed1996

[Is total thyroidectomy and lymph node excision as therapy of differentiated thyroid gland carcinomas in childhood justified?].

The extent of radical resection of differentiated thyroid carcinomas in children (< 18 years) is discussed controversially because of good prognosis, on the one hand, but a high rate of lymph node metastases, greater tumor size, lung metastases and tumor recurrences on the other. Because of our data we advocate thyroidectomy, cervical lymph node dissection and postoperative 131J-therapy as the treatment of choice in patients with manifest disease in order of further detection and/or treatment of lung metastases. Limited radicality (i.e. hemithyroidectomy) should be reserved for children with small and occult tumors.

Adenocarcinoma, Follicular↗
PubMed2002

[Adenocarcinoma of the esophagus: prognostic comparison between transthoracic esophageal resection with expanded 2-field lymph node dissection and trans-hiatal esophageal dissection with abdominal lymph node excision].

A retrospective analysis should compare the two operative approaches, transhiatal or transthoracic resection in patients suffering from adenocarcinoma of the esophagus. Between 1985 and 2002 123 cases were presented with adenocarcinoma of the esophagus, treated in 65% by transhiatal resection including abdominal lymph node dissection and in 35% by the transthoracic approach with standardized extended mediastinal and abdominal lymph node dissection. Hospital mortality was 14% (6/43) after transthoracic resection and 3.8% (3/80) after transhiatal resection (ns). Die number of removed and examined abdominal lymph nodes following transhiatal resection was 14.1 (mean) versus 12.3 (mean) after transthoracic resection (ns). Die number of removed and examined mediastinal lymph nodes by transhiatal resection was 6.3 (mean) versus 19.7(mean) after transthoracic resection (p < 0.001). The median survival after transthoracic approach was 19 months versus 20 months after transhiatal approach (ns). Median survival of curatively resected patients (R0) were in both operative procedures similar (21 months). A more differentiated analysis referred to the UICC stages also demonstrated no differences in the survival between transthoracic and transhiatal resection. With respect to less mortality and less morbidity after transhiatal resection and because of the not detectable prognostic advantage of the transthoracic resection we suggest the transhiatal approach as the treatment of choice in patients with adenocarcinoma of the esophagus.

Abdomen↗
PubMedDate not supplied

[Considerations on lymph node excision in the surgery of stomach cancers].

The use of extensive lymphadenectomy is based on a historical comparison of results before 1950, when only subtotal gastrectomy was used, and after 1950 when variably extensive lymphadenectomy was associated to visceral exeresis. At the beginning, we involved neither the retroduodenopancreatic lymph nodes nor the juxtahilar nodes of the hepatic pedicle in this lymphadenectomy, and we actually performed only type R2 lymphadenectomy. After 1965, exeresis was extended to said lymph nodes, thus becoming a type R2-R3 operation. As far as viscéral exeresis is concerned, our indication to extend exeresis has been defined according to the site of the tumor, to the degree of infiltration of the gastric wall and to the histological type, rather than to a principle. Thus we have after used subtotal gastrectomy, with 33.3% survival after five years, 30% after ten years and 29% after 12-15 years for the cases of the first period (R2 lymphadenectomy). With type R2-R3 lymphadenectomy, survival is 35.5% at five years and 32.5% at ten years. Total gastrectomy (always with splenectomy) has been performed in all cases of proximal extension, of juxtacardial and fundal location, of multifocal lesions and of poorly differentiated histological types (86 cases). During the period or R2 lymphadenectomy, we had 33.3% survival at five years and 25% at ten years, vs. 36.2% at five years and 32% at ten years in the second period. In properly indicated subtotal resection, R2 lymphadenectomy extending to some third-level areas provides better survival, with acceptable morbidity and mortality.(ABSTRACT TRUNCATED AT 250 WORDS)

Follow-Up Studies↗
PubMed2006

The importance of central compartment elective lymph node excision in the staging and treatment of papillary thyroid cancer.

OBJECTIVE: To determine the incidence of nodal involvement and assess the role of elective lymph node (LN) exploration and/or dissection in staging of tumors and treatment of patients with papillary thyroid cancer. DESIGN: Retrospective medical chart review. SETTING: Academic tertiary care medical center. PATIENTS: One hundred patients diagnosed with papillary thyroid cancer by fine-needle aspiration or intraoperative frozen section who underwent total thyroidectomy with central compartment cervical LN exploration. MAIN OUTCOME MEASURE: Incidence of positive LNs in patients 45 years or older (group A) vs those younger than 45 years (group B). RESULTS: Sixteen (39%) of 41 patients in group A had positive LN status following LN exploration and/or dissection. Seventeen (29%) of 59 patients in group B were found to have positive LNs. According to the American Joint Committee on Cancer staging system, the tumors of 11 patients (28%) in group A would be restaged from stage I/II to stage III after establishment of the positive pathologic nodal status. CONCLUSIONS: Lymph node metastasis was present in the central compartment in 39% of patients in group A. Presence of LN metastasis in older patients has been reported to increase the risk of recurrence of papillary thyroid carcinoma. Furthermore, recurrence and reoperation in the central compartment is associated with a higher risk of vocal cord paralysis. In patients in group A diagnosed with papillary thyroid carcinoma, routine central compartment LN exploration and/or dissection at the time of thyroidectomy is advocated, which allows more accurate staging of tumors and appropriate treatment. Elective excision of central compartment LNs in this older age group may improve locoregional control and possibly reduce morbidity in the long run.

Adult↗
PubMed1991

[Extensive lymph node excision in the surgical treatment of esophageal and gastric cancer].

Experience with 100 operations for carcinoma of the esophagus and stomach with expanded lymphadenectomy is analysed. The operative techniques are described and the necessity and expediency of expanded lymphadenectomy, the method of its performance, classification of the group of lymph nodes which must be removed are discussed. The postoperative mortality was 2%, complications in the postoperative period 25%. Metastases in the lymph nodes were confirmed histologically in 69% of cases. It is concluded that expanded lymphadenectomy is a necessary measure in surgical intervention in patients with carcinoma of the esophagus and stomach and improves the results of management of this group of patients.

Adenocarcinoma↗