{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,8]],"date-time":"2026-07-08T04:49:02Z","timestamp":1783486142022,"version":"3.55.0"},"reference-count":29,"publisher":"Oxford University Press (OUP)","issue":"4","license":[{"start":{"date-parts":[[2013,2,4]],"date-time":"2013-02-04T00:00:00Z","timestamp":1359936000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/academic.oup.com\/journals\/pages\/open_access\/funder_policies\/chorus\/standard_publication_model"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2013,2,4]]},"abstract":"<jats:title>Abstract<\/jats:title>\n               <jats:sec>\n                  <jats:title>Background<\/jats:title>\n                  <jats:p>Papillary thyroid carcinoma (PTC) frequently metastasizes to regional lymph nodes. Metastasis to the posterior neck, level V, is uncommon, and level V lymphadenectomy may lead to spinal accessory nerve injury and associated postoperative morbidities. The aim of this study was to assess the diagnostic efficiency of preoperative ultrasonography and to identify predictors of level V metastasis in patients with PTC.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Methods<\/jats:title>\n                  <jats:p>This study involved patients with previously untreated PTC that had metastasized to the lateral neck, and who underwent total thyroidectomy with central and lateral neck dissection. Histopathological findings were compared with ultrasound results for various neck levels. Clinical and histopathological factors that predicted level V metastasis were identified.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Results<\/jats:title>\n                  <jats:p>Of 143 patients, 26 (18\u00b72 per cent) had lymph node metastasis at level V. The sensitivity and positive predictive value of ultrasonography for level V metastasis were 46\u00b72 and 30\u00b70 per cent respectively. Univariable analysis showed that male sex, extranodal disease extension, a metastatic lymph node ratio in the ipsilateral lateral neck of more than 0\u00b72, and simultaneous involvement of ipsilateral levels II\u2013IV or level III were associated with ipsilateral level V metastasis. Multivariable analysis revealed an independent association between macroscopic extranodal disease extension and level V metastasis (odds ratio 26\u00b705, 95 per cent confidence interval 5\u00b763 to 120\u00b756; P &amp;lt; 0\u00b7001).<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Conclusion<\/jats:title>\n                  <jats:p>Preoperative ultrasonography frequently failed to detect level V metastasis in patients with metastatic PTC. Level V lymphadenectomy may be considered in patients with lymph node metastasis in the ipsilateral lateral neck with macroscopic extranodal extension.<\/jats:p>\n               <\/jats:sec>","DOI":"10.1002\/bjs.9024","type":"journal-article","created":{"date-parts":[[2012,12,19]],"date-time":"2012-12-19T11:37:23Z","timestamp":1355917043000},"page":"497-503","source":"Crossref","is-referenced-by-count":34,"title":["Preoperative detection and predictors of level V lymph node metastasis in patients with papillary thyroid carcinoma"],"prefix":"10.1093","volume":"100","author":[{"given":"M J","family":"Shim","sequence":"first","affiliation":[{"name":"Department of Otolaryngology, University of Ulsan College of Medicine , Seoul,","place":["Korea"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"J-L","family":"Roh","sequence":"additional","affiliation":[{"name":"Department of Otolaryngology, University of Ulsan College of Medicine , Seoul,","place":["Korea"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"G","family":"Gong","sequence":"additional","affiliation":[{"name":"Department of Pathology, University of Ulsan College of Medicine , Seoul,","place":["Korea"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"K-J","family":"Choi","sequence":"additional","affiliation":[{"name":"Department of Pathology, University of Ulsan College of Medicine , Seoul,","place":["Korea"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"J H","family":"Lee","sequence":"additional","affiliation":[{"name":"Department of Radiology, Asan Medical Centre, University of Ulsan College of Medicine , Seoul,","place":["Korea"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"S-H","family":"Cho","sequence":"additional","affiliation":[{"name":"Department of Otolaryngology, University of Ulsan College of Medicine , Seoul,","place":["Korea"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"S Y","family":"Nam","sequence":"additional","affiliation":[{"name":"Department of Otolaryngology, University of Ulsan College of Medicine , Seoul,","place":["Korea"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"S Y","family":"Kim","sequence":"additional","affiliation":[{"name":"Department of Otolaryngology, University of Ulsan College of Medicine , Seoul,","place":["Korea"]},{"name":"Department of Biomedical Research Institute, Korea Institute of Science and Technology , Seoul,","place":["Korea"]}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"286","published-online":{"date-parts":[[2013,3,1]]},"reference":[{"key":"2024092904545357300_bib1","doi-asserted-by":"crossref","first-page":"418","DOI":"10.1016\/0002-9343(94)90321-2","article-title":"Long-term impact of initial surgical and medical therapy on papillary and follicular thyroid 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