American Association of Endocrine SurgeonInfluence of prophylactic central lymph node dissection on postoperative thyroglobulin levels and radioiodine treatment in papillary thyroid cancer
Section snippets
Patients
After approval by the institutional review board, a retrospective cohort review was performed of a single institutional database of consecutive patients who had operative treatment of PTC at the University of Michigan from 2002 to 2009. Patients who underwent TT were designated as group TT, whereas those undergoing TT with prophylactic bilateral central compartment lymph node dissection (BCLND) were designated group TT + BCLND. Patients with a primary tumor size <1 cm, evident preoperative
Results
Of the 390 patients treated surgically for PTC from 2002 to 2009, 143 patients met inclusion criteria; 247 patients were excluded based on the following criteria: 44 for previous operation for thyroid cancer, 39 for tumor size <1 cm, 22 for preoperative abnormal lymph nodes, 36 for incomplete data, 3 for distant metastasis at diagnosis, and 103 for nodal dissection outside the central neck. Sixty-five patients underwent TT alone and 78 underwent TT + BCLND. Patient characteristics are presented
Discussion
All endocrine surgeons agree that grossly involved lymph nodes in the central neck of patients with thyroid cancer should be managed by clearance of the central neck compartment lymph nodes.1 The management of the central lymph nodes for clinically node-negative PTC, however, continues to be a controversial issue. The case for routine central neck dissection cites the >50% incidence of metastatic cervical lymph node involvement in PTC and the associated increase in local recurrence rates and
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