Should central lymph node dissection be considered for all papillary thyroid microcarcinoma?

Asian Journal of Surgery

卷:39

Hoon Yub Kim¹  Gil Soo Son¹  Jeoung Won Bae¹  Jae Bok Lee¹  Young Woo Chang¹  Hwan Soo Kim¹ 

[1] Department of Breast Endocrine Surgery, Korea University Medical Center, Seoul, Republic of Korea;

关键词: central lymph node;    papillary thyroid cancer;    papillary thyroid microcarcinoma;   

DOI  :  10.1016/j.asjsur.2015.02.006

来源: DOAJ

【 摘 要 】

Background: Central lymph node dissection (CLND) in patients with papillary thyroid microcarcinoma (PTMC) is still controversial. The aim of this study was to examine the risk factors and the incidence of central lymph node metastases (CLNMs) in patients with PTMC who underwent thyroidectomy and CLND.Patients and methods: Between 2002 and 2013, 613 patients were enrolled who underwent thyroidectomy with routine CLND for PTMC at the Korea University Medical Center, Ansan Hospital and risk factors and the incidence of CLNM were analyzed. In addition, we also evaluated the complications after thyroidectomy with CLND.Results: Out of 613 patients, 239 (39.0%) were found to have CLNM. Male sex (p = 0.012), tumor size ≥ 0.5 cm (p = 0.001), capsular invasion or extrathyroidal extension (p = 0.029), and multifocality (p = 0.004) were independent risk factors for CLNM. Among the 69 patients who had PTMC without these risk factors, CLNM was identified in 12 (17.4%). In this study group, two (0.3%) had permanent recurrent laryngeal nerve injury, two (0.3%) had persistent hypocalcemia, and two (0.3%) developed postoperative hemorrhage.Conclusion: CLNM in PTMC is highly prevalent in male sex, tumor size ≥ 0.5 cm, extrathyroidal extension, and multifocality. Even in PTMC patients without these risk factors, the incidence of CLNM is rather higher than expected, and the complication rate of thyroidectomy with CLND is acceptable. Thus, CLND should be considered in all patients with PTMC.

【 授权许可】

Unknown