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Related Experiment Video

Updated: May 31, 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

Performing contralateral central lymph node dissection in papillary thyroid carcinoma: a decision approach.

Byung Joo Chae1, Chan Kwon Jung, Dong Jun Lim

  • 1Department of Surgery, Catholic University of Korea, Seoul, Korea.

Thyroid : Official Journal of the American Thyroid Association
|July 13, 2011
PubMed
Summary

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Routine intraoperative frozen section of central lymph nodes in papillary thyroid cancer (PTC) can guide decisions on contralateral dissection, potentially reducing morbidity without compromising safety.

Area of Science:

  • Oncology
  • Surgical Oncology
  • Head and Neck Surgery

Background:

  • Controversy exists regarding prophylactic neck dissection in papillary thyroid carcinoma (PTC).
  • Current strategies involve routine bilateral central lymph node dissection (CLND) or selective approaches.
  • Assessing the need for contralateral CLND is crucial for optimizing patient outcomes.

Purpose of the Study:

  • To evaluate a strategy of selective contralateral CLND based on intraoperative frozen section analysis of ipsilateral central lymph nodes (CLNs) in unilateral PTC.
  • To compare the morbidity and efficacy of this selective approach versus routine bilateral CLND.

Main Methods:

  • A prospective, nonrandomized study of 203 patients with unilateral PTC and no clinical adenopathy.
  • Patients underwent elective ipsilateral CLND with intraoperative frozen section analysis.

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Last Updated: May 31, 2026

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  • Contralateral CLND was performed only if the frozen section was positive for malignancy.

    • Main Results:

    • No significant difference in major complications between unilateral and bilateral CLND groups.
    • Transient hypocalcemia rates were lower in the unilateral CLND group (31.8%) compared to the bilateral CLND group (45.7%).
    • Frozen section of the ipsilateral CLN demonstrated 78.3% sensitivity and 100% specificity for predicting contralateral CLN metastasis.

    Conclusions:

    • Intraoperative frozen section analysis of ipsilateral CLNs is valuable for assessing contralateral metastasis risk in unilateral PTC.
    • This approach can guide decisions regarding contralateral CLND, potentially reducing morbidity.
    • Selective contralateral CLND based on frozen section results appears safe and effective.