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Updated: Apr 20, 2026

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

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

Published on: September 15, 2023

Is central lymph node dissection necessary for parathyroid carcinoma?

Kun-Tai Hsu¹, Rebecca S Sippel¹, Herbert Chen¹

¹Section of Endocrine Surgery, Department of Surgery, University of Wisconsin, Madison, WI.

|December 3, 2014

Summary

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Lymph node metastasis is not a significant factor for survival in parathyroid carcinoma. However, larger tumors (≥ 3 cm) are linked to a higher risk of lymph node metastasis.

Area of Science:

Endocrinology
Oncology
Surgical Pathology

Background:

Parathyroid carcinoma is a rare endocrine malignancy.
The prognostic significance of lymph node (LN) metastasis in parathyroid carcinoma is not well-established.
Understanding prognostic factors is crucial for patient management.

Purpose of the Study:

To investigate the impact of lymph node (LN) metastasis on disease-specific survival (DSS) in parathyroid carcinoma.
To identify predictors of lymph node metastasis in parathyroid carcinoma.

Main Methods:

Retrospective analysis of the Surveillance, Epidemiology, and End Result (SEER) database.
Inclusion of parathyroid carcinoma cases diagnosed between 1988 and 2010.
Multivariate analysis to identify independent prognostic factors.

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Main Results:

Out of 405 patients, 114 had LNs examined, with 10.5% showing positive metastasis.
Tumor size ≥ 3 cm and distant metastasis, but not LN metastasis, were independent prognostic factors for DSS.
Tumor size ≥ 3 cm was the only predictor of LN metastasis, with these tumors being 7.5 times more likely to metastasize to LNs.

Conclusions:

While tumors ≥ 3 cm increase the risk of LN metastasis, positive LN status does not independently affect DSS in parathyroid carcinoma.
Tumor size serves as a potential risk stratification tool for predicting LN metastasis.