Dongbin Ahn1, Jin Ho Sohn2, Ji Young Park3. 1. Department of Otorhinolaryngology-Head and Neck Surgery, School of Medicine, Kyungpook National University, Daegu, Republic of Korea. 2. Department of Otorhinolaryngology-Head and Neck Surgery, School of Medicine, Kyungpook National University, Daegu, Republic of Korea. Electronic address: entgodlikeu@gmail.com. 3. Department of Pathology, School of Medicine, Kyungpook National University, Daegu, Republic of Korea.
Abstract
OBJECTIVES: To evaluate surgical complications and recurrence patterns after central neck dissection (CND) in papillary thyroid carcinoma (PTC). METHODS: A retrospective analysis was performed on 361 patients who underwent total thyroidectomy with or without CND for PTC from 2000 to 2007. Clinicopathological results and recurrence were stratified according to treatment modality. RESULTS: Incidence of occult central metastasis of PTC was 64.3%. With respect to surgical morbidities, the total thyroidectomy (TT) with CND group exhibited a significantly higher incidence of transient vocal fold paralysis (10.0% vs 3.4%, p=0.029) and permanent hypocalcaemia (11.4% vs 4.5%, p=0.041), and significantly prolonged mean operating time (195.8min vs 153.0min, p<0.001) than the TT alone group. Analysis of the recurrence patterns revealed that level IV was most commonly involved in both groups. When the location of recurrence was categorised into central and lateral neck, the recurrence rate in the lateral neck was significantly higher than that in the central neck, regardless of initial CND. CONCLUSIONS: CND was associated with permanent hypocalcaemia and transient vocal fold paralysis. The lateral neck was mainly involved in recurrence regardless of initial CND, suggesting the clinical benefit of CND may be small.
OBJECTIVES: To evaluate surgical complications and recurrence patterns after central neck dissection (CND) in papillary thyroid carcinoma (PTC). METHODS: A retrospective analysis was performed on 361 patients who underwent total thyroidectomy with or without CND for PTC from 2000 to 2007. Clinicopathological results and recurrence were stratified according to treatment modality. RESULTS: Incidence of occult central metastasis of PTC was 64.3%. With respect to surgical morbidities, the total thyroidectomy (TT) with CND group exhibited a significantly higher incidence of transient vocal fold paralysis (10.0% vs 3.4%, p=0.029) and permanent hypocalcaemia (11.4% vs 4.5%, p=0.041), and significantly prolonged mean operating time (195.8min vs 153.0min, p<0.001) than the TT alone group. Analysis of the recurrence patterns revealed that level IV was most commonly involved in both groups. When the location of recurrence was categorised into central and lateral neck, the recurrence rate in the lateral neck was significantly higher than that in the central neck, regardless of initial CND. CONCLUSIONS: CND was associated with permanent hypocalcaemia and transient vocal fold paralysis. The lateral neck was mainly involved in recurrence regardless of initial CND, suggesting the clinical benefit of CND may be small.
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