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- Title
Central Lymph Node Dissection Improves Lymph Node Clearance in Papillary Thyroid Cancer Patients with Lateral Neck Metastases, Even after Prior Total Thyroidectomy.
- Authors
HALL, CHAD M.; SNYDER, SAMUEL K.; LAIRMORE, TERRY C.
- Abstract
The oncologic benefit of a central lymph node dissection (CLND) at the time of modified radical neck dissection (MRND) in patients with papillary thyroid cancer who have previously undergone a total thyroidectomy (TT) has not been studied. Patients with lateral cervical metastases were divided into two treatment groups: the concurrent cohort (TT with CLND and MRND), and the interval cohort (CLND and MRND after prior TT). Primary outcomes were lymph node metastases, skip metastases, level VI cancer recurrence, hypoparathyroidism and recurrent laryngeal nerve injury. Treatment groups consisted of 63 and 16 patients in the concurrent and interval groups, respectively. More central lymph nodes were removed (15.4 ± 8.4 to 10.1 ± 5.2 (P = 0.02)), but similar level VI lymph node metastasis occurred (92.0-93.8% (P = 0.99)) in the concurrent group compared with the interval group, respectively. Skip metastases were identified in only 7.6 per cent of patients. The incidence of level VI recurrence and recurrent laryngeal nerve injury was 1.2 per cent. Three patients developed hypoparathyroidism (3.7%). All permanent morbidities occurred in the concurrent group. CLND at the time of MRND for metastatic papillary thyroid cancer frequently identifies level VI metastases and can be done with low operative morbidity by experienced endocrine surgeons, even in patients who have undergone a prior TT.
- Subjects
LYMPH node surgery; DISSECTION; THYROID cancer; CANCER relapse; CERVICAL cancer; HYPOPARATHYROIDISM; LONGITUDINAL method; LYMPH nodes; METASTASIS; NECK surgery; THYROID gland tumors; THYROIDECTOMY; TREATMENT effectiveness; RETROSPECTIVE studies; PAPILLARY carcinoma
- Publication
American Surgeon, 2018, Vol 84, Issue 4, p531
- ISSN
0003-1348
- Publication type
journal article
- DOI
10.1177/000313481808400426