Korean J Otorhinolaryngol-Head Neck Surg.  2015 Nov;58(11):769-775. 10.3342/kjorl-hns.2015.58.11.769.

Analysis of Treatment Results after Thyroid Lobectomy with Prophylactic Ipsilateral Central Neck Lymph Node Dissection for Low-Risk Papillary Thyroid Carcinoma: A Single Institute Experience

• Choi JY
• Kim MJ
• Lim I
• Lee GH
• Lee BC
• Choi IJ
• Lee MC

• KMID: 2129807
• DOI: http://doi.org/10.3342/kjorl-hns.2015.58.11.769

Abstract

BACKGROUND AND OBJECTIVES
Surgical options for low-risk papillary thyroid carcinoma (PTC) have been in debate. The purpose of this study was to analyze the treatment results of lobectomy and prophylactic ipsilateral central lymph node dissection (cND) for low-risk PTC.
SUBJECTS AND METHOD
We retrospectively analyzed 906 patients who were diagnosed as PTC pre- or post-operatively and underwent lobectomy and/or prophylactic ipsilateral cND from 2001 to 2010. Studied variables were clinicopathologic data, complications, sites of recurrence, overall survival, and recurrence free survival rates.
RESULTS
Fifty two (5.7%) patients showed recurrence during follow-up. Of the 52 recurrent cases, 32 (61.5%) cases recurred in a remnant thyroid only, 11 (21.2%) cases in a lymph node (LN) only, and 9 (17.3%) cases in a remnant thyroid and the LN. One (0.1%) patient showed permanent vocal cord palsy. Overall survival rate at 10 years was 99.6%. Overall recurrence free survival rates at 5 and 10 years were 97.1% and 81.0%, respectively. Risk factors for recurrences were old age (>45), contralateral nodule(s) at initial surgery, large tumor, no prophylactic cND, and pathological LN metastasis.
CONCLUSION
Lobectomy with prophylactic ipsilateral cND may be a good option for low risk PTC patients due to excellent overall survival rates, recurrence rates, and minimal complication rates.

Keyword

Central lymph node dissection; Lobectomy; Papillary thyroid carcinoma; Recurrence; Thyroidectomy

MeSH Terms

Follow-Up Studies
Humans
Lymph Node Excision*
Lymph Nodes*
Neck*
Neoplasm Metastasis
Recurrence
Retrospective Studies
Risk Factors
Survival Rate
Thyroid Gland*
Thyroid Neoplasms*
Thyroidectomy
Vocal Cord Paralysis