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Selective lateral compartment neck dissection for thyroid cancer.

Kellen Welch¹, Christopher R McHenry

¹Northeast Ohio Medical University, Rootstown, Ohio, USA.

The Journal of Surgical Research

|July 3, 2013

Summary

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Selective lateral compartment neck dissection (LCND) effectively treats thyroid cancer with lymph node metastases, showing an 8% recurrence rate in differentiated thyroid cancer. However, neuropathic symptoms are a significant source of morbidity.

Area of Science:

Oncology
Surgical Oncology
Head and Neck Surgery

Background:

Compartment-oriented lymph node dissection is crucial for managing thyroid cancer with macroscopic lymph node metastases, impacting recurrence and survival.
The optimal extent of lymph node dissection in thyroid cancer surgery remains a subject of ongoing debate.
Selective lateral compartment neck dissection (LCND) is a surgical approach evaluated for its efficacy in treating thyroid cancer.

Purpose of the Study:

To evaluate the outcomes of selective lateral compartment neck dissection (LCND) in patients with thyroid cancer.
To assess the extent of lymph node resection, associated morbidity, recurrence rates, and survival following LCND.
To provide data on the effectiveness of LCND as a therapeutic strategy for thyroid cancer.

Main Methods:

Keywords:

Selective lateral compartment neck dissection Thyroid cancer

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Retrospective review of patients who underwent selective LCND between 1992 and 2012.
Analysis of lymph node resection extent, including anatomical levels involved (IIA, III, IV, VB).
Assessment of surgical morbidity, recurrence rates, reoperation frequency, mortality, and duration of patient follow-up.

Main Results:

A total of 45 LCNDs were performed in 40 patients (35 differentiated thyroid cancer, 5 medullary carcinoma).
Morbidity included neck/ear numbness (48%) and neuropathic symptoms (35%); Horner syndrome and marginal mandibular nerve paresis occurred in 5% each.
The overall recurrence rate was 25%, with 3 ipsilateral recurrences (8%) in differentiated thyroid cancer patients. Four patients died from systemic disease.

Conclusions:

Selective LCND is an effective treatment for macroscopic lymph node metastases in thyroid cancer, achieving an 8% ipsilateral recurrence rate in differentiated thyroid cancer.
While effective in reducing recurrence, neuropathic symptoms represent a significant morbidity associated with selective LCND.
The study highlights the balance between oncologic control and functional outcomes in lateral neck dissection for thyroid cancer.