Michael W Deutschmann1, Laura Chin-Lenn2, Jennifer Au3, Alan Brilz4, Steve Nakoneshny5, Joseph C Dort5,6, Janice L Pasieka2,7, Shamir P Chandarana5,6. 1. Department of Otolaryngology-Head & Neck Surgery, University of Kansas Medical Center, Kansas City, Kansas. 2. Division of Surgical Oncology, Department of Surgery, University of Calgary, Calgary, Alberta, Canada. 3. Department of Family Medicine, Faculty of Medicine, University of Calgary, Calgary, Alberta, Canada. 4. Department of Family Medicine, Faculty of Medicine and Dentistry, University of Alberta, Edmonton, Alberta, Canada. 5. Ohlson Research Initiative, Southern Alberta Cancer Research Institute, University of Calgary, Calgary, Alberta, Canada. 6. Division of Otolaryngology-Head and Neck Surgery, Department of Surgery, University of Calgary, Calgary, Alberta, Canada. 7. Division of Endocrinology, Department of Medicine, University of Calgary, Calgary, Alberta, Canada.
Abstract
BACKGROUND: It is unclear if surgeons are performing comprehensive central neck dissections for well-differentiated thyroid cancer. The purpose of this study was to determine mean lymph node retrieval in central neck dissection as well as variability across surgeons and institutions. METHODS: A prospectively collected database identified 18 surgeons performing 425 central neck dissections, 313 unilateral and 112 bilateral. Demographics, perioperative, and pathologic factors were analyzed. RESULTS: Mean lymph node yield was 7.4 and 11.9 for unilateral and bilateral central neck dissection, respectively. Although 224 central neck dissections were prophylactic, both total and pathologic lymph node yields were significantly higher in therapeutic central neck dissection. There was a significant variation in lymph node yield across individual surgeons, institutions, and regions. High-volume central neck dissection surgeons have significantly lower lymph node yield compared to low-volume surgeons. CONCLUSION: Central neck dissection seems to be performed adequately; however, there is a significant variation in lymph node yield. Future initiatives should try to standardize the central neck dissections performed, with emphasis on obtaining a sufficient yield.
BACKGROUND: It is unclear if surgeons are performing comprehensive central neck dissections for well-differentiated thyroid cancer. The purpose of this study was to determine mean lymph node retrieval in central neck dissection as well as variability across surgeons and institutions. METHODS: A prospectively collected database identified 18 surgeons performing 425 central neck dissections, 313 unilateral and 112 bilateral. Demographics, perioperative, and pathologic factors were analyzed. RESULTS: Mean lymph node yield was 7.4 and 11.9 for unilateral and bilateral central neck dissection, respectively. Although 224 central neck dissections were prophylactic, both total and pathologic lymph node yields were significantly higher in therapeutic central neck dissection. There was a significant variation in lymph node yield across individual surgeons, institutions, and regions. High-volume central neck dissection surgeons have significantly lower lymph node yield compared to low-volume surgeons. CONCLUSION: Central neck dissection seems to be performed adequately; however, there is a significant variation in lymph node yield. Future initiatives should try to standardize the central neck dissections performed, with emphasis on obtaining a sufficient yield.
Authors: Michael W Deutschmann; Laura Chin-Lenn; Steven C Nakoneshny; Joseph C Dort; Janice L Pasieka; Shamir P Chandarana Journal: J Otolaryngol Head Neck Surg Date: 2016-10-28
Authors: Steven J Craig; Andrew M Bysice; Steven C Nakoneshny; Janice L Pasieka; Shamir P Chandarana Journal: Thyroid Date: 2020-01-09 Impact factor: 6.568