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Transoral Robotic Total Thyroidectomy and Bilateral Central Regional Lymph Node Dissection for Papillary Thyroid Carcinoma
Published on: September 15, 2023
759
Prophylactic Central Compartment Dissection on the Long-Term Outcome of Advanced (N0-T3/T4) Papillary Thyroid Cancer
A K Revathy1, Sidhu R Sekhar1, C Gopalakrishnan Nair1
1Dept. of General Surgery, Amrita Institute of Medical Science and Research Centre, Flat No 15 C, Kent Palm Grove 2, Stadium Link Road, Opp. IMA House, Palarivattom P.O., Kochi, 682041 Kerala India.
Summary
Prophylactic central compartment dissection does not improve long-term outcomes for advanced papillary thyroid cancer. This surgical approach did not significantly affect recurrence or survival rates in node-negative patients.
Area of Science:
- Oncology
- Surgical Oncology
- Endocrine Surgery
Background:
- Advanced papillary thyroid cancer (T3/T4, N0) requires careful surgical consideration.
- Prophylactic central compartment dissection is a complex procedure with potential complications.
- Its benefit in node-negative advanced thyroid cancer remains debated.
Purpose of the Study:
- To evaluate the impact of prophylactic central compartment dissection on long-term outcomes in advanced, node-negative papillary thyroid cancer.
- To compare recurrence rates, disease-free survival, and overall survival between patients who underwent prophylactic central compartment dissection and those who did not.
Main Methods:
- Retrospective case-control study of 55 patients with advanced (T3/T4, N0) papillary thyroid cancer treated between 2005 and 2010.
- Comparison of total thyroidectomy with prophylactic central compartment dissection versus total thyroidectomy alone.
- Median follow-up of 115 months.
Main Results:
- No significant difference in loco-regional recurrence rates between the two groups (14% vs. 12%, p=0.463).
- Disease-free survival and overall survival were comparable between groups.
- A trend towards increased permanent hypoparathyroidism was observed in the central compartment dissection group.
Conclusions:
- Prophylactic central compartment dissection does not influence the 10-year outcomes of advanced node-negative papillary thyroid cancers.
- The routine use of this extensive dissection in this patient group may not be warranted.
- Potential for increased complications like hypoparathyroidism should be considered.
