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Transoral Robotic Total Thyroidectomy and Bilateral Central Regional Lymph Node Dissection for Papillary Thyroid Carcinoma
Published on: September 15, 2023
Surgical extent of central lymph node dissection in clinically node-negative papillary thyroid cancer
Wan Wook Kim1, Ho Yong Park, Jin Hyang Jung
1Department of Surgery, School of Medicine, Kyungpook National University, Daegu, Korea.
Head & Neck
|January 17, 2013
Summary
For unilateral papillary thyroid carcinoma (PTC) patients without lymph node spread, bilateral central lymph node dissection is recommended if the tumor is larger than 1 cm or shows extrathyroidal extension. This helps predict metastasis risk.
Area of Science:
- Oncology
- Surgical Oncology
- Head and Neck Surgery
Background:
- The necessity of bilateral central lymph node dissection (CLND) for clinically node-negative, unilateral papillary thyroid carcinoma (PTC) remains unverified.
- Predictive factors for lymph node metastasis require further investigation to guide surgical extent.
Purpose of the Study:
- To identify predictive factors for lymph node metastasis in unilateral PTC.
- To establish guidelines for the surgical extent of CLND in these patients.
Main Methods:
- Retrospective analysis of 325 patients with unilateral PTC who underwent total thyroidectomy and bilateral CLND between 2004 and 2009.
- Statistical analysis to determine significant predictors of ipsilateral and contralateral lymph node metastasis.
Main Results:
- Central lymph node metastasis occurred in 45.2% of patients.
- Tumor size >1.0 cm and extrathyroidal extension predicted ipsilateral metastasis (p = .004, < .001).
- Extrathyroidal extension and ipsilateral metastasis predicted contralateral metastasis (p = .039, < .001).
Conclusions:
- Bilateral CLND may be considered for unilateral PTC patients with extrathyroidal extension.
- Consider bilateral CLND for unilateral PTC patients with ipsilateral lymph node metastasis.
