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Updated: Jan 4, 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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Randomized trial of prophylactic ipsilateral central lymph node dissection in patients with clinically node negative
Bo Young Kim1, Nayeon Choi2, Sun Wook Kim3
1Department of Otorhinolaryngology-Head and Neck Surgery, Sanggye Paik Hospital, College of Medicine, Inje University, Seoul, Republic of Korea.
Summary
Prophylactic central neck dissection (pCND) in papillary thyroid microcarcinoma (PTMC) patients with no lymph node metastasis did not improve recurrence-free survival. This procedure cleared occult metastases but offered no significant oncological benefit.
Area of Science:
- Endocrinology
- Surgical Oncology
- Head and Neck Surgery
Background:
- Papillary thyroid microcarcinoma (PTMC) is a small form of thyroid cancer.
- Clinically node-negative (cN0) PTMC patients often undergo surgery.
- The role of prophylactic central neck dissection (pCND) in cN0 PTMC remains debated.
Purpose of the Study:
- To evaluate the oncological benefit of prophylactic ipsilateral central neck dissection (pCND) in patients with clinically node-negative (cN0) papillary thyroid microcarcinoma (PTMC).
Main Methods:
- A randomized controlled trial involving 164 cN0 PTMC patients.
- Patients were assigned to hemithyroidectomy with (n=82) or without (n=82) pCND.
- Outcomes assessed included recurrence-free survival, complications, and lymph node metastasis rates.
Main Results:
- pCND identified occult lymph node metastasis in 50% of cases.
- No significant differences in operation time, hospital stay, or complications between groups.
- Five-year recurrence-free survival was similar; three regional recurrences in pCND(+) vs. one in pCND(-) group.
Conclusions:
- Ipsilateral pCND effectively identifies occult central compartment lymph node metastases in cN0 PTMC.
- However, pCND did not demonstrate a significant oncological benefit in terms of recurrence-free survival for these patients.
