The prevalence and features of the Delphian lymph nodes' involvement in patients with papillary thyroid carcinoma

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Abstract There is ongoing debate on the extent of dissection in patients with papillary thyroid cancer. Evaluating Delphian lymph nodes (DLNs) at the time of the procedure could be helpful in determining the extent of dissection. The objective of this study was to evaluate the frequency and features of DLN in patients with papillary thyroid carcinoma. Methods This cross-sectional study included patients who underwent PTC surgery for papillary thyroid carcinoma. The patients were classified according to whether their DLNs were involved. Age, sex, mass location, lymphatic involvement, tumor size, tumor features, pathology report, and parts of the surgical note were compared between the two groups. The final pathology slides of the patients were evaluated for DLN features. Results Among the 61 patients (mean age:38.2 ± 12.0), 45 (73.8%) were female. Of the 13 patients (21.3%), one patient's interaction with DLNs was documented. Other lymph nodes on the same side (P = 0.001), opposite side (P = 0.041), and central lymph nodes (P = 0.001) were significantly associated with DLN involvement. Furthermore, vascular invasion was significantly higher in patients with DLN involvement (P = 0.012). Conclusion As DLN involvement is strongly linked to significant nodal involvement, it is suggested that DLNs be evaluated during surgery to determine the correct level of dissection.

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