Extent of central lymph node dissection for papillary thyroid carcinoma in the isthmus

Young Woo Chang, Hye Yoon Lee, Hwan Soo Kim, Hoon Yub Kim, Jae Bok Lee, Gil Soo Son

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    17 Citations (Scopus)


    Purpose: The incidence of papillary thyroid carcinoma (PTC) arising from the isthmus is low; however, these tumors have aggressive clinical and pathological features. Moreover, the existing guidelines regarding the extent of surgery for this type of tumor are unclear. Methods: This study enrolled 282 patients who underwent total thyroidectomy with bilateral central lymph node dissection. The patients were divided into 2 groups based on the location of the median line of the PTC. Group I included patients in whom the median line was located between the lateral margins of the trachea; group II included all others. We compared the 2 groups and conducted a multivariate analysis to assess risk factors for contralateral node metastasis from a PTC arising from the isthmus. Results: Patients in group I had significantly higher frequencies of extrathyroidal extension and central lymph node metastasis. Group I also had a higher frequency of contralateral node metastasis, and a tumor size >1.0 cm was identified as an independent risk factor for contralateral node metastasis among patients in this group. Conclusion: Bilateral central lymph node dissection could be considered for patients with isthmic PTCs >1.0 cm in size who have clinically suspicious node metastasis.

    Original languageEnglish
    Pages (from-to)229-234
    Number of pages6
    JournalAnnals of Surgical Treatment and Research
    Issue number5
    Publication statusPublished - 2018 May


    • Lymph node excision
    • Papillary thyroid carcinoma
    • Papillary thyroid microcarcinoma

    ASJC Scopus subject areas

    • Surgery


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