Dilek Yazıcı1, Bülent Çolakoğlu2, Burçin Sağlam3, Havva Sezer4, Yersu Kapran5, Özlem Aydın6, Mehmet Onur Demirkol7, Faruk Alagöl4, Tarık Terzioğlu8. 1. Section of Endocrinology and Metabolism, Medical School, Koç University, Istanbul, Turkey. dyazici@ku.edu.tr. 2. Section of Radiology, Amerikan Hospital, Istanbul, Turkey. 3. Department of Internal Medicine, Koç University Hospital, Istanbul, Turkey. 4. Section of Endocrinology and Metabolism, Medical School, Koç University, Istanbul, Turkey. 5. Department of Pathology, Koç University Medical School, Istanbul, Turkey. 6. Department of Pathology, Faculty of Medicine, Acıbadem Mehmet Ali Aydinlar University, Istanbul, Turkey. 7. Department of Nuclear Medicine, Koç University Medical School, Istanbul, Turkey. 8. Section of General and Endocrine Surgery, American Hospital, Istanbul, Turkey.
Abstract
PURPOSE: Morbidity due to papillary thyroid carcinoma (PTC) is increased mostly due to lymph node (LN) metastases, which lead to reoperations and complications associated with these operations. The aim is to compare the outcomes of PTC having total thyroidectomy and prophylactic central lymph node dissection (TT + PCND) with patients having total thyroidectomy (TT) alone. METHODS: This study is a retrospective cohort analysis of 358 PTC patients that were operated by a single surgeon in a single center. Data about the patients were extracted from the medical records. RESULTS: Of the patient cohort, 258 patients had TT + PCND (42.5 ± 11.3 years) and 100 patients (41.2 ± 11.9 years) had only TT. Total number of LN extracted in the TT + PCND group was 8.1 ± 6.9. The mean number of metastatic LN were 2.2 ± 1.9. Percentage of patients that had RAI were less in the TT + PCND group compared to the TT group. Seven patients (2.7%) in the TT + PCND group and 19 (19.0%) in TT group had recurrent disease (p < 0.0001). Of the complications, only transient hypoparathyroidism was increased in TT + PCND group compared to TT group (26.7% vs 10%, p < 0.0001). CONCLUSION: TT + PCND performed by an experienced surgeon seems to decrease the number of LN recurrences, and the need for reoperations.
PURPOSE: Morbidity due to papillary thyroid carcinoma (PTC) is increased mostly due to lymph node (LN) metastases, which lead to reoperations and complications associated with these operations. The aim is to compare the outcomes of PTC having total thyroidectomy and prophylactic central lymph node dissection (TT + PCND) with patients having total thyroidectomy (TT) alone. METHODS: This study is a retrospective cohort analysis of 358 PTCpatients that were operated by a single surgeon in a single center. Data about the patients were extracted from the medical records. RESULTS: Of the patient cohort, 258 patients had TT + PCND (42.5 ± 11.3 years) and 100 patients (41.2 ± 11.9 years) had only TT. Total number of LN extracted in the TT + PCND group was 8.1 ± 6.9. The mean number of metastatic LN were 2.2 ± 1.9. Percentage of patients that had RAI were less in the TT + PCND group compared to the TT group. Seven patients (2.7%) in the TT + PCND group and 19 (19.0%) in TT group had recurrent disease (p < 0.0001). Of the complications, only transient hypoparathyroidism was increased in TT + PCND group compared to TT group (26.7% vs 10%, p < 0.0001). CONCLUSION: TT + PCND performed by an experienced surgeon seems to decrease the number of LN recurrences, and the need for reoperations.
Entities:
Keywords:
Lymph node metastasis; Papillary thyroid cancer; Prophylactic central lymph node dissection; Thyroid cancer recurrences; Total thyroidectomy
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