Find in Library

Summary: Objective: The aim of the study was to determine the optimal extent of prophylactic central neck dissection (pCND) in papillary thyroid carcinoma (PTC). Materials and methods: We studied 384 patients with clinically node-negative unilateral PTC who had undergone total thyroidectomy with pCND. Of these, 169 patients underwent unilateral pCND, and 215, bilateral pCND. Results: Age, sex, and TNM stage did not differ between the two groups. The rates of occult central lymph node metastasis were 34.3% and 37.2% in the unilateral and bilateral pCND groups, respectively (p = 0.558). Metastasis to the contralateral paratracheal lymph node occurred in 4.2% of the bilateral pCND group. Major complication rates did not differ between the two groups, except for transient hypoparathyroidism, which was higher in the bilateral group (43.7% vs. 33.7%, p = 0.047). Stimulated thyroglobulin and RAI ablation uptake rates were similar in the two groups, as were recurrence and disease-free survival. Conclusion: Contralateral paratracheal node dissection may be not indicated for prophylactic central neck dissection in clinically node-negative unilateral PTC because the rate of contralateral paratracheal node metastasis is low and transient hypoparathyroidism is higher following bilateral dissection. Keywords: central neck dissection, occult lymph node metastasis, papillary thyroid carcinoma, prophylactic neck dissection