Secondary central compartment surgery for thyroid cancer

Abstract

SCCS is feasible but does carry some risk. The long-term implications of early intervention in this setting are still largely unknown and will warrant future research.

Local recurrence of papillary thyroid cancer

“…Other groups have even stated that central neck recurrences can be dealt with no special risk for the patient [14,15]. This is at variance with other reports stressing the fact that reoperations on compartment VI are associated with a higher risk of inferior laryngeal nerve injury and hypoparathyroidism, even in expert hands [16][17][18]. A recent meta-analysis supports the implementation of prophylactic neck dissection in terms of decreasing local recurrences [19].…”

Pattern and Risk Factors of Central Compartment Lymph Node Metastasis in Papillary Thyroid Cancer: A Prospective Study from an Endocrine Surgery Centre

“…On the other hand Rosenbaum and McHenry [7], reported, no significantly reduced recurrence rate with central neck dissection, but an increased risk of temporary hypocalcemia, compared with no central cervical lymph nodes dissection group. The rationale behind the routine dissection of central compartment lymph nodes in preoperatively diagnosed cases of PTC with clinically uninvolved lymph nodes is manifold; first, the PTC has the tendency for lymphatic spread, which tends to follow a sequential pattern with ipsilateral paratracheal followed by contralateral paratracheal and ipsilateral lateral cervical lymph nodes [3, 4]; secondly, it provides accurate tumor staging to facilitate accurate prognosis and adjuvant therapy [6]; lastly, the long-term morbidity of CCD in primary setting in experienced hands is comparable with total thyroidectomy alone [5, 9] and even though if it is higher [10, 26], it is still lower than the morbidity of central compartment lymph nodes dissection (CCD) done in reoperative setting [27]. Roh et al [28], in their prospective series of 45 patients with recurrent PTC detected 86.7% recurrences in central compartment, with high rates of temporary and permanent complications with reoperation.…”

Recurrent Differentiated Thyroid Cancer

“…Central compartment dissection for recurrent PTC, while carrying an increased risk for hypoparathyroidism and recurrent laryngeal nerve injury, remains the treatment modality of choice for regional recurrent or metastatic disease [13,49]. Central neck dissection entails removal of all soft tissues in level VI and VII neck compartments in a patient who previously underwent thyroidectomy or central lymph node dissection.…”