Routine central lymph node dissection with total thyroidectomy for papillary thyroid cancer potentially minimizes...

Area of Science:

• Endocrinology
• Surgical Oncology
• Thyroid Cancer Research

Background:

• Papillary thyroid cancer treatment strategies lack robust evidence from randomized trials.
• Central lymph node dissection (CLND) benefits are debated, particularly routine bilateral dissection.
• This study analyzes recurrence and complication rates of routine bilateral CLND.

Purpose of the Study:

• To evaluate the efficacy and safety of routine bilateral central lymph node dissection (CLND) in papillary thyroid cancer.
• To assess the impact of CLND on local recurrence rates.
• To determine complication rates associated with routine bilateral CLND.

Main Methods:

• Retrospective review of 266 papillary thyroid cancer patients undergoing total thyroidectomy with CLND (2000-2015).
• Analysis of patient demographics, tumor characteristics, surgical procedures, adjuvant therapy, and recurrence data.
• Primary outcome assessment included cancer recurrence, recurrent laryngeal nerve injury, and hypoparathyroidism.

Main Results:

• 39.8% of patients had lymph node metastases to level VI.
• Papillary thyroid cancer recurred in 4 patients (1.5%) with a mean tumor size of 1.6 cm.
• Low rates of temporary (3.4%) and permanent (0.4%) recurrent laryngeal nerve injury and permanent hypoparathyroidism (1.5%) were observed.

Conclusions:

• Routine bilateral CLND is safe and feasible for papillary thyroid cancer in experienced endocrine surgeons.
• CLND does not increase recurrent laryngeal nerve injury risk when performed routinely.
• Bilateral CLND with total thyroidectomy may reduce central compartment recurrence in papillary thyroid cancer.