Clinical analysis of prophylactic central neck dissection for papillary thyroid carcinoma

Abstract

PurposeThe need of prophylactic central neck dissection (PCND) in patients with papillary thyroid carcinoma (PTC) is still controversial. The major restriction of PCND is the potential complications. We undertook a retrospective study to discuss its necessity in PTC patients.MethodsA total of 188 patients with PTC who underwent total thyroidectomy and PCND were involved. In all of these, central lymph nodes were pathologic examined. Univariate and multivariate analyses were performed based on tumor location and size, etc.ResultsOverall, node metastases were found in 44.1 % (83/188) of patients. Tumor size was the independent positive predictor for lymph node metastasis, while gender, age, tumor multifocality, tumor location, and capsular infiltration were not independent predictors of central lymph node metastases. Postoperative complications happened in 5.3 % (10/188) of patients, which 4.8 % (9/188) had temporary hypocalcemia and 0 % (0/188) had permanent hypocalcemia. Rates of temporary and permanent recurrent laryngeal nerve injury were 0.5 % (1/188) and 0 % (0/188), respectively.ConclusionsPCND is recommended in all patients with PTC.

Comparison of Completion Thyroidectomy and Primary Total Surgery for Differentiated Thyroid Cancer: A Meta-Analysis

“…One of these 2 studies [9] did not consider the presence of lymph nodes in the surgical specimens, and the other one [5] found a similar incidence of hypocalcemia. Although our study cohort was short of these data, some authors indicated that central lymph node dissection was not a risk factor for postoperative hypocalcemia [21,22].…”

Comparison of the Incidence of Postoperative Hypocalcemia following Total Thyroidectomy vs Completion Thyroidectomy

“…Although the lack of these data in our work may be considered a weakness, several authors showed that central neck dissection per se is not a risk factor for postoperative hypocalcemia. [16][17][18][19][20] In summary, our study demonstrates that CT is associated with a significantly lower rate of hypocalcemia than TT. The rate of hypocalcemia was independent of autotransplantation of a parathyroid gland in the TT group.…”

Papillary thyroid carcinoma, evaluation of prophylactic central compartment’s dissection versus conservative management: a prospective study

“…43 CLN metastasis is considered the most important risk factor for local recurrence. 44 Also it decreases survival and it is related to distant metastasis. 45,46 Bardet et al, stated that the risk of recurrence was low in patients without macroscopic LN involvement; even if pCLND was not applied.…”