J Korean Surg Soc.  2010 Nov;79(5):332-339. 10.4174/jkss.2010.79.5.332.

Is Central Lymph Node Dissection Mandatory in 2 cm or Less Sized Papillary Thyroid Cancer?

• Chung YS
• Suh YJ

• KMID: 2212037
• DOI: http://doi.org/10.4174/jkss.2010.79.5.332

Abstract

PURPOSE
There have been controversies on the scope of central lymph node dissection (CND) in papillary thyroid cancer (PTC). We performed this study to determine the role of CND for patients having PTC measuring 2 cm or less.
METHODS
530 cases of PTC less than 2 cm had undergone lobectomy plus isthmectomy (LI) with CND or without CND. Clinicopathologic records and clinical outcome were evaluated, retrospectively.
RESULTS
Comparing recurrence rates in LI with CND group (4/174, 2.30%) and LI without CND group (16/356, 4.49%), there was no significant statistical difference in recurrence (P=0.331). We compared 20 patients with recurrences and 510 patients of no recurrence. The size of tumor seemed to influence recurrence (P<0.001) and the size of tumor developing recurrence was larger than the other (1.11 cm vs. 0.75 cm). When considering division into PTC and papillary thyroid microcarcinoma (PTMC), PTMC showed less recurrence significantly (P=0.006). No other variables such as age, sex, tumor location, extrathyroidal extension seemed to be related to the recurrence.
CONCLUSION
We could not find any relevant role of CND to prevent recurrence either locally or regionally in cases of no lymph node metastasis after CND for patients having PTC measuring 2 cm or less. Moreover, prophylactic CND is not mandatory for all cases of PTC less than 2 cm.

Keyword

Papillary thyroid cancer; Central lymph node dissection; Recurrence; Prophylactic lymph node dissection

MeSH Terms

Carcinoma, Papillary
Factor IX
Humans
Lymph Node Excision
Lymph Nodes
Neoplasm Metastasis
Recurrence
Thyroid Gland
Thyroid Neoplasms
Carcinoma, Papillary
Factor IX
Thyroid Neoplasms

Figure

• 

  Fig. 1 Kaplan-Meier survival curve plotted by whether papillary thyroid microcarcinoma present or not.

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