Extent of prophylactic lymph node dissection in the central neck area of the patients with papillary thyroid carcinoma: comparis

Abstract
Background  To compare the “comprehensive” (including bilateral paratracheal, pretracheal, prelaryngeal lymph nodes) (CCND) with “limited”
(saving contralateral paratracheal lymph nodes) central node dissection (LCND) for postoperative complications and disease
recurrence rate in sonographically node-negative papillary thyroid carcinomas.

Materials and Methods  From 2003 to 2005, 114 consecutive patients, diagnosed as sonographically node-negative thyroid papillary carcinomas, were
included retrospectively. Among them, the LCND was performed in 56 patients and CCND in 58 patients, in combination with total
thyroidectomy, based on the operator-dependent decision. We compared the complication rates and the recurrence rates between
these two groups with a mean follow-up duration of 2 years.

Results  Transient hypocalcemia was more frequent in the CCND group than in the LCND group (48.3% vs 26.8%, P = .02, odds ratio [OR] = 2.55). However, the other complication rates were similar in the two groups. In addition, the immediate
postoperative reduction of parathyroid hormone (PTH) was more evident in the CCND group. The postoperative PTH levels increased
up to a similar level (12.4 vs 11.8 pg/mL) over 6 months. The incidence of permanent hypocalcemia did not differ significantly
between the two groups. Four (7.1%) and five recurrences (8.6%) were found in two groups, respectively, implying similar oncological
safety during the 2-year follow-up.

Conclusion  The LCND with total thyroidectomy could be an alternative treatment option for node-negative papillary thyroid carcinomas,
because LCND had fewer short-term hypocalcemia and similar oncological outcomes during the 2-year follow-up. Further study
enrolling a large number of patients with long-term follow-up is needed.

Content Type Journal ArticleCategory Endocrine TumorsDOI 10.1245/s10434-008-9928-8Authors
Young-Ik Son, Samsung Medical Center, Sungkyunkwan University School of Medicine Department of Otorhinolaryngology—Head and Neck Surgery Seoul KoreaHan-Sin Jeong, Samsung Medical Center, Sungkyunkwan University School of Medicine Department of Otorhinolaryngology—Head and Neck Surgery Seoul KoreaChung-Hwan Baek, Samsung Medical Center, Sungkyunkwan University School of Medicine Department of Otorhinolaryngology—Head and Neck Surgery Seoul KoreaMan Ki Chung, Samsung Medical Center, Sungkyunkwan University School of Medicine Department of Otorhinolaryngology—Head and Neck Surgery Seoul KoreaJunsun Ryu, National Cancer Center Head and Neck Oncology Clinic, Center for Special Organs Ilsan KoreaJae Hoon Chung, Samsung Medical Center, Sungkyunkwan University School of Medicine Department of Endocrinology Seoul KoreaYoon Kyung So, Samsung Medical Center, Sungkyunkwan University School of Medicine Department of Otorhinolaryngology—Head and Neck Surgery Seoul KoreaJeon Yeob Jang, Samsung Medical Center, Sungkyunkwan University School of Medicine Department of Otorhinolaryngology—Head and Neck Surgery Seoul KoreaJeesun Choi, Samsung Medical Center, Sungkyunkwan University School of Medicine Department of Otorhinolaryngology—Head and Neck Surgery Seoul Korea

Journal Annals of Surgical OncologyOnline ISSN 1534-4681Print ISSN 1068-9265 (Source: Annals of Surgical Oncology)  MedWorm Sponsored Message: Find out how you can get your message across here by sponsoring this MedWorm news feed.