Prophylactic Central Compartment Dissection on the Long-Term Outcome of Advanced (N0-T3/T4) Papillary Thyroid Cancer

To see whether prophylactic central compartment dissection is recommended for advanced papillary thyroid cancer or as part of selective neck node dissection. Central compartment dissection is a technically demanding surgical procedure and carries a higher incidence of complications. The present retrospective case-control study analysed the impact of prophylactic central compartment dissection on the long-term outcome of advanced (N0-T3/T4) papillary thyroid cancer.

Case records of patients operated on for papillary thyroid cancer from 2005 to 2010 were reviewed and patients with Tumour stage 3-4 and N0 nodal status were included in the study. The institutional protocol was to perform total thyroidectomy with central compartment dissection during the early phase of the study period (2005 to 2008) but this strategy was shifted to total thyroidectomy alone during the latter phase. Fifty-five patients were included in the study and 29 of the cohort had total thyroidectomy with prophylactic central compartment dissection as the primary surgery and the remaining 26 had a total thyroidectomy as the primary surgical procedure.

Patients were followed up for a median duration of 115 months and found to have no significant difference in the incidences of loco-regional recurrences between the groups. (n:4 (14%) Vs n: 3 (12%) p = .463). The disease-free survival and overall survival were not significantly different in the groups. There was a trend to an increase in the incidence of permanent hypoparathyroidism in patients who had central compartment dissection.

Prophylactic central compartment dissection did not influence the 10-year outcome of advanced node-negative papillary thyroid cancers.