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Role of prophylactic ipsilateral central compartment lymph node dissection in papillary thyroid microcarcinoma.

 Mujgan Caliskan  ;  Jae Hyun Park  ;  Jun Soo Jeong  ;  Cho-Rok Lee  ;  Seul Kee Park  ;  Sang-Wook Kang  ;  Jong Ju Jeong  ;  Woong Youn Chung  ;  Cheong Soo Park 
 ENDOCRINE JOURNAL, Vol.59(4) : 305-311, 2012 
Journal Title
Issue Date
Adult ; Carcinoma ; Carcinoma, Papillary/surgery ; Cohort Studies ; Female ; Follow-Up Studies ; Humans ; Lymph Node Excision* ; Lymph Nodes/surgery ; Lymphatic Metastasis/pathology ; Male ; Middle Aged ; Neck Dissection ; Neoplasm Recurrence, Local/pathology ; Postoperative Complications/etiology ; Retrospective Studies ; Thyroid Neoplasms/pathology* ; Thyroid Neoplasms/surgery* ; Vocal Cord Paralysis/etiology
Prophylatic central compartment node dissection ; Papillary thyroid microcarcinoma ; Recurrence ; Surgical outcome
Central compartment lymph node (CCLN) management in patients without clinical or radiologic evidence of CCLN metastasis is debatable. The aim of the present study was to evaluate outcomes of surgery for papillary thyroid microcarcinoma (PTMC) with prophylactic ipsilateral CCLN dissection (PI-CCND) in a large cohort of patients treated at one single institution in a 5-year follow-up. Between January 2000 and December 2005, 2192 patients with papillary thyroid carcinoma underwent thyroid surgery. Inclusion criteria were patients with PTMC, absence of clinical or radiologic evidence of CCLN metastasis, and a follow-up for a period ≥60 months. Data from 842 patients were retrieved in the current retrospective cohort study. PI-CCND was routinely performed in addition to thyroid surgery in all cases. Ipsilateral CCLN metastasis was found in 218 patients (25.9%). Postoperative complications included 76 cases of transient hypoparathyroidism (9%), 11 cases of permanent hypoparathyroidism (2.6%), four cases of vocal cord palsy (0.5%), and one case of bleeding (0.1%). Univariate analysis and multivariate logistic regression analysis revealed that CCLN metastasis was statistically significantly correlated with tumor size and extracapsular invasion. Recurrence has been observed to date in 19 patients (2.26%). No CCLN site recurrence occured in patients who underwent PI-CCND. This study demonstrates the technical feasibility and safety of PI- CCND, which is a better way to determine lymph node status for a more accurate staging of disease and risk stratification. PI-CCND should be considered even if clinical or radiological exams are negative for CCLN metastasis.
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1. College of Medicine (의과대학) > Dept. of Surgery (외과학교실) > 1. Journal Papers
Yonsei Authors
Kang, Sang Wook(강상욱) ORCID logo https://orcid.org/0000-0001-5355-833X
Park, Seul Kee(박슬기) ORCID logo https://orcid.org/0000-0002-7639-1015
Park, Jae Hyun(박재현)
Park, Cheong Soo(박정수)
Lee, Cho Rok(이초록) ORCID logo https://orcid.org/0000-0001-7848-3709
Chung, Woong Youn(정웅윤)
Jeong, Jong Ju(정종주) ORCID logo https://orcid.org/0000-0002-4155-6035
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