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Related Experiment Video

Updated: Jun 20, 2026

Transoral Robotic Total Thyroidectomy and Bilateral Central Regional Lymph Node Dissection for Papillary Thyroid Carcinoma
04:01

Transoral Robotic Total Thyroidectomy and Bilateral Central Regional Lymph Node Dissection for Papillary Thyroid Carcinoma

Published on: September 15, 2023

Routine bilateral central lymph node clearance for papillary thyroid cancer.

Brian M Sadowski1, Samuel K Snyder, Terry C Lairmore

  • 1Department of Surgery, Texas A&M Health Science Center College of Medicine, Scott and White Clinic, Temple, TX 76508, USA.

Surgery
|October 1, 2009
PubMed
Summary
This summary is machine-generated.

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Bilateral central lymph node dissection (CLND) for papillary thyroid cancer (PTC) is safe and effective. This procedure helps clear metastatic disease and reduces recurrence risk without significantly increasing recurrent laryngeal nerve (RLN) injury.

Area of Science:

  • Oncology
  • Surgical Oncology
  • Head and Neck Surgery

Background:

  • Controversy exists regarding the extent of surgical treatment for paratracheal (level VI) lymph nodes in papillary thyroid cancer (PTC).
  • Local recurrence in central neck lymph nodes after thyroidectomy is challenging to manage.
  • Bilateral central lymph node dissection (CLND) may minimize recurrence risk if proven safe and oncologically sound.

Purpose of the Study:

  • To evaluate the oncological safety and efficacy of bilateral CLND in patients with PTC.
  • To assess the risk of recurrent laryngeal nerve (RLN) injury associated with bilateral CLND.
  • To determine the incidence of lymph node metastases in the central neck compartment.

Main Methods:

  • Retrospective review of 310 patients treated for PTC between 2000 and 2008.

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  • Analysis of operative procedures, tumor characteristics, RLN injury, recurrence, and reoperation rates.
  • Comparison of outcomes between patients who underwent bilateral CLND, unilateral CLND, or no CLND.

    • Main Results:

    • Central lymph nodes were positive in 46.7% of patients who underwent CLND.
    • 25.5% of patients with bilateral CLND had positive contralateral lymph nodes (excluding specific tumor types).
    • The risk of RLN injury was not significantly higher with bilateral CLND compared to other approaches (P = .18).
    • All 4 central neck recurrences requiring reoperation occurred in patients who did not have CLND.

    Conclusions:

    • Lymph node metastases are common in both ipsilateral and contralateral central lymph node basins in PTC patients.
    • Routine bilateral CLND in PTC patients can effectively clear metastatic disease.
    • Bilateral CLND appears to be a safe and oncologically justified procedure for managing PTC, without a significant increase in RLN injury risk.