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Updated: Mar 3, 2026
Transoral Robotic Total Thyroidectomy and Bilateral Central Regional Lymph Node Dissection for Papillary Thyroid Carcinoma
Published on: September 15, 2023
Optimal extent of prophylactic central neck dissection for papillary thyroid carcinoma: Comparison of unilateral
Han Seok Yoo1, Myung Chul Shin1, Yong Bae Ji1
1Department of Otolaryngology-Head and Neck Surgery, School of Medicine, Hanyang University, Seoul, Republic of Korea.
Objective:
The aim of the study was to determine the optimal extent of prophylactic central neck dissection (pCND) in papillary thyroid carcinoma (PTC).
Materials And Methods:
We studied 384 patients with clinically node-negative unilateral PTC who had undergone total thyroidectomy with pCND. Of these, 169 patients underwent unilateral pCND, and 215, bilateral pCND.
Results:
Age, sex, and TNM stage did not differ between the two groups. The rates of occult central lymph node metastasis were 34.3% and 37.2% in the unilateral and bilateral pCND groups, respectively (p = 0.558). Metastasis to the contralateral paratracheal lymph node occurred in 4.2% of the bilateral pCND group. Major complication rates did not differ between the two groups, except for transient hypoparathyroidism, which was higher in the bilateral group (43.7% vs. 33.7%, p = 0.047). Stimulated thyroglobulin and RAI ablation uptake rates were similar in the two groups, as were recurrence and disease-free survival.
Conclusion:
Contralateral paratracheal node dissection may be not indicated for prophylactic central neck dissection in clinically node-negative unilateral PTC because the rate of contralateral paratracheal node metastasis is low and transient hypoparathyroidism is higher following bilateral dissection.
