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Prophylactic neck dissection for low-risk differentiated thyroid cancers: Risk-benefit analysis
Xavier Dubernard1,2, Sandrine Dabakuyo1, Samiratou Ouedraogo1
1Thyroïde Marne-Ardennes Register, CLCC Institut Jean Godinot, Reims, France.
Head & Neck
|February 14, 2016
Summary
For differentiated thyroid cancer (DTC) without lymph nodes, neck dissection offers no significant remission or progression benefits. However, it increases the risk of permanent complications like hypoparathyroidism.
Area of Science:
- Endocrinology
- Surgical Oncology
Background:
- The role of neck dissection in differentiated thyroid cancer (DTC) remains debated.
- This study focuses on the risk-benefit of neck dissection in low-risk DTC patients with no detectable lymph nodes.
Purpose of the Study:
- To analyze the risk-benefit of performing neck dissection in patients with low-risk differentiated thyroid cancer and no detectable lymph nodes.
Main Methods:
- A retrospective study included 295 patients treated between 1983 and 2003.
- Patients underwent thyroidectomy with (C+) or without (C-) neck dissection, followed by iodine-131 therapy.
- Remission rates, disease progression, and permanent complications were compared between the two groups.
Main Results:
- The study included 212 patients in the C+ group and 83 in the C- group.
- Remission rates were similar (92% vs. 89.2%, p = .40), as was disease progression (3.3% vs. 7.2%, p = .10).
- Permanent hypoparathyroidism was significantly higher in the C+ group (15.1% vs. 3.6%, p = .006).
Conclusions:
- Neck dissection provides no demonstrated benefit for complete remission or preventing progression in low-risk DTC patients without lymph nodes.
- The risk of complications, particularly permanent hypoparathyroidism, is higher following neck dissection in this patient group.
