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Updated: Mar 13, 2026
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Transoral Robotic Total Thyroidectomy and Bilateral Central Regional Lymph Node Dissection for Papillary Thyroid Carcinoma
Published on: September 15, 2023
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Total thyroidectomy alone versus ipsilateral versus bilateral prophylactic central neck dissection in clinically
P G Calò1, G Conzo2, M Raffaelli3
1Department of Surgical Sciences, University of Cagliari, S.S. 554, Bivio Sestu, Monserrato, 09042 Cagliari, Italy.
Summary
Total thyroidectomy alone is adequate for differentiated thyroid carcinoma patients without lymph node metastasis. Central neck dissection increases morbidity without reducing recurrence, though ipsilateral dissection may aid radioactive iodine selection.
Area of Science:
- Endocrine Surgery
- Oncology
- Thyroid Cancer Research
Background:
- Central neck dissection (CND) for clinically node-negative differentiated thyroid carcinoma (DTC) is debated.
- Determining metastasis rates, morbidity, and recurrence is crucial for treatment decisions.
Purpose of the Study:
- To compare outcomes of total thyroidectomy (TT) alone versus TT with ipsilateral or bilateral CND in node-negative DTC.
- To evaluate metastasis rates, surgical morbidity, and locoregional recurrence.
- To inform treatment guidelines for clinically node-negative DTC.
Main Methods:
- Retrospective analysis of 163 clinically node-negative DTC patients from three referral centers (2008-2010).
- Patients grouped into: TT alone (A), TT with ipsilateral CND (B), TT with bilateral CND (C).
- Outcomes assessed: metastasis, hypoparathyroidism, recurrent nerve injury, and recurrence rates.
Main Results:
- Node metastases: 8.7% (A), 23.3% (B), 63.3% (C).
- Transient hypoparathyroidism: 12.6% (A), 23.3% (B), 36.7% (C).
- Locoregional recurrence: 3.9% (A), 0% (B), 0% (C).
Conclusions:
- No significant difference in locoregional recurrence rates among the three groups.
- TT alone is adequate; CND increases morbidity (hypoparathyroidism) without improving recurrence.
- Ipsilateral CND may aid radioactive iodine selection with lower hypocalcemia risk, warranting further study.
