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Related Experiment Video

Updated: Apr 14, 2026

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

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Should central lymph node dissection be considered for all papillary thyroid microcarcinoma?

Young Woo Chang1, Hwan Soo Kim1, Hoon Yub Kim1

  • 1Department of Breast Endocrine Surgery, Korea University Medical Center, Seoul, Republic of Korea; Department of Surgery, Korea University College of Medicine, Seoul, Republic of Korea.

Asian Journal of Surgery
|April 28, 2015
PubMed
Summary

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Central lymph node dissection (CLND) for papillary thyroid microcarcinoma (PTMC) is recommended, even in low-risk cases. CLND in PTMC patients revealed a high incidence of central lymph node metastases (CLNMs), with acceptable complication rates.

Area of Science:

  • Oncology
  • Surgical Oncology
  • Endocrine Surgery

Background:

  • The necessity of central lymph node dissection (CLND) for papillary thyroid microcarcinoma (PTMC) remains a subject of debate.
  • This study investigates the prevalence and risk factors associated with central lymph node metastases (CLNMs) in PTMC patients undergoing thyroidectomy and CLND.

Purpose of the Study:

  • To identify independent risk factors for CLNM in PTMC patients.
  • To determine the incidence of CLNM in PTMC patients, including those without identified risk factors.
  • To evaluate the complication rate associated with thyroidectomy and CLND.

Main Methods:

  • A retrospective analysis of 613 patients who underwent thyroidectomy with routine CLND for PTMC between 2002 and 2013.
  • Statistical analysis to identify risk factors for CLNM.
Keywords:
central lymph nodepapillary thyroid cancerpapillary thyroid microcarcinoma

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Last Updated: Apr 14, 2026

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  • Assessment of postoperative complications such as recurrent laryngeal nerve injury, hypocalcemia, and hemorrhage.

    • Main Results:

    • Central lymph node metastases (CLNM) were detected in 39.0% of the 613 patients.
    • Independent risk factors for CLNM included male sex, tumor size ≥ 0.5 cm, capsular invasion/extathyroidal extension, and multifocality.
    • Even in patients without these risk factors (n=69), CLNM was found in 17.4% (12 patients).
    • The complication rate was low, with permanent recurrent laryngeal nerve injury in 0.3%, persistent hypocalcemia in 0.3%, and postoperative hemorrhage in 0.3%.

    Conclusions:

    • CLNM is prevalent in PTMC, particularly in patients with specific risk factors like male sex, larger tumor size, extrathyroidal extension, and multifocality.
    • A significant incidence of CLNM exists even in PTMC patients lacking these conventional risk factors.
    • Thyroidectomy with CLND is associated with an acceptable complication profile, supporting its consideration for all PTMC patients.