Korean J Endocr Surg.  2011 Dec;11(4):262-268. 10.0000/kjes.2011.11.4.262.

Prophylactic Central Compartment Node Dissection for Papillary Thyroid Carcinoma: Complication and Outcome

• Jeong JS
• Lee JY
• Lee SJ
• Koong SS
• Park JW

• KMID: 2375388
• DOI: http://doi.org/10.0000/kjes.2011.11.4.262

Abstract

PURPOSE
Prophylactic central compartment node dissection is gaining acceptance in the treatment of papillary thyroid carcinoma (PTC). However, its benefits remain controversial. The aim of study was to evaluate the effects of prophylactic central compartment node dissection on the complication rate and the short-term disease-free survival rate.
METHODS
Our treatment strategy for PTC without clinical evidence of lymph node metastasis has been changed from total thyroidectomy alone (group I) to total thyroidectomy with prophylactic central compartment node dissection (group II) since January 2007. Before and after 2007, 70 consecutive patients were selected in each group.
RESULTS
The average age of patients was 46.3±11.8 years. Average follow-up period was 51.9±10.9 months. The average size of maximum diameters of the tumors was 1.3±0.8 cm. Lymph node metastasis was identified in 22.9% of patients in group II. Recurrent laryngeal nerve injury occurred in one patient in each group. Temporary and permanent hypoparathyroidism occurred in 32.9% and 2.9% in group I, 40.0% and 7.1% in group II respectively (P=0.483 and P=0.441, respectively). Locoregional recurrences developed in seven patients in group I. Fifty month disease-free survival rate was 90.0% and 100% in group I and group II, respectively (P=0.0078).
CONCLUSION
Prophylactic central compartment node dissection did not seem to increase the risk of recurrent laryngeal nerve injury, but may increase the risk of temporary and permanent hypoparathyroidism. Prophylactic central compartment node dissection decreased the risk of locoregional recurrences, especially in central compartment. However, the size of metastatic lymph nodes in central compartment in the present study was relatively small and their clinical implication remains to be evaluated.

Keyword

Prophylactic central compartment node dissection; Papillary thyroid cancer; Complication; Hypoparathyroidism; Disease free survival

MeSH Terms

Disease-Free Survival
Follow-Up Studies
Humans
Hypoparathyroidism
Lymph Nodes
Neoplasm Metastasis
Recurrence
Recurrent Laryngeal Nerve Injuries
Thyroid Gland*
Thyroid Neoplasms*
Thyroidectomy