Faculty, Staff and Student Publications

Language

English

Publication Date

1-1-2026

Journal

Head & Neck

DOI

10.1002/hed.70027

PMID

40891104

PMCID

PMC12703554

PubMedCentral® Posted Date

9-1-2025

PubMedCentral® Full Text Version

Post-print

Abstract

Background: Retropharyngeal lymph node (RPLN) metastases in thyroid cancer are rare, with optimal management underreported.

Methods: Retrospective study of consecutive thyroid cancer patients with RPLN metastases treated at MD Anderson Cancer Center between 2000 and 2024.

Results: One hundred and sixty-seven patients (75% differentiated, 21% medullary, 4% poorly differentiated thyroid cancer) were divided into three groups: active surveillance (AS) (13%), surgery (56%), and nonsurgical treatment (31%). In the AS group (median follow-up 2.3 years), RPLN metastases grew a median 3% (range: 0-56) or 0.02 cm (range: 0-0.7) per year. Surgical therapy included transcervical (73%), transoral robotic (14%), transoral (12%), and transmandibular (1%) approaches. Median RPLN metastasis size was 1.7 cm (interquartile range: 1.3-2.2) at surgery. Three months post-operatively, 11% had dysphagia and 1% had velopharyngeal insufficiency. Nonsurgical treatments included radioactive iodine (10%), radiation therapy (11%), and systemic targeted therapy (79%).

Conclusion: RPLN metastases grow slowly, and those ≥ 1 cm typically undergo surgical resection without significant long-term morbidity.

Keywords

Humans, Thyroid Neoplasms, Retrospective Studies, Male, Female, Middle Aged, Lymphatic Metastasis, Adult, Thyroidectomy, Aged, Lymph Nodes

Published Open-Access

yes

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