BACKGROUND: There is controversy regarding the need for prophylactic level VI central node dissection in patients with low-risk papillary thyroid carcinoma (PTC). This study focuses on the incidence of persistent level VI nodal disease in low-risk PTC without prophylactic central node dissection. METHODS: PTC was known at the time of thyroidectomy in 304 of the 761 patients who had initial thyroid surgery from 2001 to 2007. Therapeutic level VI node dissection was performed for suspicious or positive nodes. A prophylactic central node dissection was not done if suspicious nodes were not identified. All patients had a high-resolution ultrasonography, and almost all patients had a suppressed serum thyroglobulin level 4-6 months after thyroidectomy. RESULTS: A total of 112 of 304 patients (37%) had a therapeutic level VI node dissection. A prophylactic central node dissection was not performed in the remaining 192 patients. One hundred and sixty-one of the 192 patients (84%) were low risk. Biopsy-proven persistent disease was identified at the 4-6-month postoperative ultrasonography in only 3 of the 161 low-risk patients (1.8%). The suppressed serum thyroglobulin level was increased in these 3 patients and 2 additional patients. CONCLUSION: Failure to perform a prophylactic central node dissection in low-risk PTC resulted in both a very low incidence of persistent level VI nodal disease and elevated suppressed thyroglobulin 4-6 months after thyroidectomy.
BACKGROUND: There is controversy regarding the need for prophylactic level VI central node dissection in patients with low-risk papillary thyroid carcinoma (PTC). This study focuses on the incidence of persistent level VI nodal disease in low-risk PTC without prophylactic central node dissection. METHODS: PTC was known at the time of thyroidectomy in 304 of the 761 patients who had initial thyroid surgery from 2001 to 2007. Therapeutic level VI node dissection was performed for suspicious or positive nodes. A prophylactic central node dissection was not done if suspicious nodes were not identified. All patients had a high-resolution ultrasonography, and almost all patients had a suppressed serum thyroglobulin level 4-6 months after thyroidectomy. RESULTS: A total of 112 of 304 patients (37%) had a therapeutic level VI node dissection. A prophylactic central node dissection was not performed in the remaining 192 patients. One hundred and sixty-one of the 192 patients (84%) were low risk. Biopsy-proven persistent disease was identified at the 4-6-month postoperative ultrasonography in only 3 of the 161 low-risk patients (1.8%). The suppressed serum thyroglobulin level was increased in these 3 patients and 2 additional patients. CONCLUSION: Failure to perform a prophylactic central node dissection in low-risk PTC resulted in both a very low incidence of persistent level VI nodal disease and elevated suppressed thyroglobulin 4-6 months after thyroidectomy.
Authors: I J Nixon; L Y Wang; I Ganly; S G Patel; L G Morris; J C Migliacci; R M Tuttle; J P Shah; A R Shaha Journal: Br J Surg Date: 2015-10-29 Impact factor: 6.939
Authors: Panagiotis Asimakopoulos; Ashok R Shaha; Iain J Nixon; Jatin P Shah; Gregory W Randolph; Peter Angelos; Mark E Zafereo; Luiz P Kowalski; Dana M Hartl; Kerry D Olsen; Juan P Rodrigo; Vincent Vander Poorten; Antti A Mäkitie; Alvaro Sanabria; Carlos Suárez; Miquel Quer; Francisco J Civantos; K Thomas Robbins; Orlando Guntinas-Lichius; Marc Hamoir; Alessandra Rinaldo; Alfio Ferlito Journal: Curr Oncol Rep Date: 2020-11-14 Impact factor: 5.075
Authors: Alexander Rehders; Martin Anlauf; Ilona Adamowsky; Markus H Ghadimi; Sarah Klein; Christina Antke; Kenko Cupisti; Nikolas H Stoecklein; Wolfram T Knoefel Journal: Pathol Oncol Res Date: 2013-08-06 Impact factor: 3.201