Total thyroidectomy with and without prophylactic central compartment neck dissection in early papillary thyroid cancer: A comparative study

Abstract

Back ground: Among all types of cancer, thyroid cancer is regarded as the most prevalent endocrine cancer with a high incidence. This is due to the fact that papillary carcinomas can be largely detectable sub-clinically. Occult lymph node metastasis in PTC have a high-rate incidence. Ideal management of such a type of thyroid cancer requires a central compartment neck dissection (pCCND), despite the fact that the contribution of pCCND to manage PTC is controversial with regard to its merits as well as risks. Subject and method: In this study, we compared total thyroidectomy with or without pCCND in case of papillary thyroid cancer with a clinically negative cervical LN metastasis. The study concentrates mainly on the complication rate and the risk of disease recurrence. A prospective comparative study was conducted by collecting 40 cases of papillary thyroid cancer with clinical negative LNs operated between March 2017 and March 2019, 20 of them (group1) underwent total thyroidectomy and 20 cases (group2) underwent total thyroidectomy and pCCND. Results: The average operative time in group (1) was estimated of (122.1 ± 19.1 min), while in group (2) it was (182.2 ± 15.3 min) with a statistically significant relationship. Only one case 5% in group (2) cases suffered from hoarseness of voice. 5% of group (1) and 10% of group (2) suffered from transient hypocalcemia, one case (5%) in group (1) had recurrence and 4 cases (20%) of group (2) cases suffered from recurrence. Conclusion: Total thyroidectomy with pCCND done in cases suffering from PTC with clinically negative cervical LNs increases time of operation and post-operative hospital stay compared to total thyroidectomy with no statistical difference as regard to surgical complications and post-operative recurrence especially with the presence of post-operative radioactive ablation. Highlights

Incidence and Risk Factors of Thyroid Malignancy in Patients with Toxic Nodular Goiter

“…Patients who have SNG with documented risk factors of malignancy should be scheduled for surgery to catch malignancy at early stages, and we suggest that patients should potentially need preoperative FNA for dominate nodules to rule-out malignancy, which will change the timing of surgery to catch malignancy at early stages, and protect patients with papillary thyroid carcinoma from neck LNs dissection, as reported by Hisham Omran et.al. that total thyroidectomy without prophylactic central LN dissection in early papillary thyroid cancer with no statistical difference as regard to postoperative recurrence especially with presence of postoperative radioactive ablation [ 22 ].…”