Role of Prophylactic Central Compartment Lymph Node Dissection on the Outcome Of Patients With Papillary Thyroid Carcinoma and Synchronous Ipsilateral Cervical Lymph Node Metastases.
Journal
Endocrine practice : official journal of the American College of Endocrinology and the American Association of Clinical Endocrinologists
ISSN: 1530-891X
Titre abrégé: Endocr Pract
Pays: United States
ID NLM: 9607439
Informations de publication
Date de publication:
Aug 2020
Aug 2020
Historique:
received:
12
11
2019
accepted:
02
03
2020
entrez:
20
1
2021
pubmed:
21
1
2021
medline:
23
1
2021
Statut:
ppublish
Résumé
Prophylactic central compartment lymph node dissection (pCCND) results in a higher percentage of surgical-related complications. To date, no evidence of the impact of pCCND on the clinical outcome of papillary thyroid carcinoma (PTC) patients with synchronous ipsilateral cervical lymph node metastases has been reported. We evaluated all consecutive patients affected by PTC and synchronous ipsilateral cervical, but without evidence of central compartment, lymph node metastases. We selected 54 consecutive patients (group A) treated by total thyroidectomy, ipsilateral cervical lymph node dissection, and pCCND and 115 patients (group B) matched for sex, age at diagnosis, number and dimension of the metastatic lateral cervical lymph nodes, without pCCND. Clinical outcome after a median of 5 years and surgical-related complications were assessed. The two groups were completely similar in terms of clinical features. Clinical outcomes showed a higher percentage of biochemical and indeterminate but not structural response in group B. Group B required significantly more radioiodine treatments, but no difference was shown in the need to repeat surgery for recurrences. Conversely, the prevalence of permanent hypoparathyroidism was significantly higher in group A (14.8%) than in group B (4.3%). In PTC patients with synchronous ipsilateral cervical lymph node metastases, in absence of clinically evident lymph node metastases of the central compartment, performing pCCND does not improve the 5-year outcome in terms of structural disease, despite a greater number of IQR = interquartile range; pCCND = prophylactic central compartment lymph node dissection; PTC = papillary thyroid carcinoma; Tg = thyroglobulin; US = ultrasound.
Identifiants
pubmed: 33471672
pii: S1530-891X(20)48164-9
doi: 10.4158/EP-2019-0532
pii:
doi:
Substances chimiques
Iodine Radioisotopes
0
Types de publication
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Pagination
807-817Informations de copyright
© 2020 American Association of Clinical Endocrinologists. Published by Elsevier, Inc. All rights reserved.