TY - JOUR
T1 - Should central lymph node dissection be considered for all papillary thyroid microcarcinoma?
AU - Chang, Young Woo
AU - Kim, Hwan Soo
AU - Kim, Hoon Yub
AU - Lee, Jae Bok
AU - Bae, Jeoung Won
AU - Son, Gil Soo
N1 - Funding Information:
Conflicts of interest: This study was supported by Korea University Grant ( K1032401 ).
Publisher Copyright:
© 2015
PY - 2016/10/1
Y1 - 2016/10/1
N2 - 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.
AB - 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.
KW - central lymph node
KW - papillary thyroid cancer
KW - papillary thyroid microcarcinoma
UR - http://www.scopus.com/inward/record.url?scp=84928041550&partnerID=8YFLogxK
U2 - 10.1016/j.asjsur.2015.02.006
DO - 10.1016/j.asjsur.2015.02.006
M3 - Article
C2 - 25913730
AN - SCOPUS:84928041550
SN - 1015-9584
VL - 39
SP - 197
EP - 201
JO - Asian Journal of Surgery
JF - Asian Journal of Surgery
IS - 4
ER -