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Optimal extent of prophylactic central neck dissection for papillary thyroid carcinoma: Comparison of unilateral versus bilateral central neck dissection

Title
Optimal extent of prophylactic central neck dissection for papillary thyroid carcinoma: Comparison of unilateral versus bilateral central neck dissection
Author
지용배
Keywords
central neck dissection; occult lymph node metastasis; papillary thyroid carcinoma; prophylactic neck dissection
Issue Date
2018-07
Publisher
ELSEVIER SINGAPORE PTE LTD
Citation
ASIAN JOURNAL OF SURGERY, v. 41, no. 4, page. 363-369
Abstract
Objective: The aim of the study was to determine the optimal extent of prophylactic central neck dissection (pCND) in papillary thyroid carcinoma (PTC).Materials and methods: We studied 384 patients with clinically node-negative unilateral PTC who had undergone total thyroidectomy with pCND. Of these, 169 patients underwent unilateral pCND, and 215, bilateral pCND.Results: Age, sex, and TNM stage did not differ between the two groups. The rates of occult central lymph node metastasis were 34.3% and 37.2% in the unilateral and bilateral pCND groups, respectively (p = 0.558). Metastasis to the contralateral paratracheal lymph node occurred in 4.2% of the bilateral pCND group. Major complication rates did not differ between the two groups, except for transient hypoparathyroidism, which was higher in the bilateral group (43.7% vs. 33.7%, p = 0.047). Stimulated thyroglobulin and RAI ablation uptake rates were similar in the two groups, as were recurrence and disease-free survival.Conclusion: Contralateral paratracheal node dissection may be not indicated for prophylactic central neck dissection in clinically node-negative unilateral PTC because the rate of contralateral paratracheal node metastasis is low and transient hypoparathyroidism is higher following bilateral dissection. (C) 2017 Asian Surgical Association and Taiwan Robotic Surgical Association. Publishing services by Elsevier B.V.
URI
https://www.sciencedirect.com/science/article/pii/S1015958417300118?via%3Dihubhttp://repository.hanyang.ac.kr/handle/20.500.11754/119404
ISSN
1015-9584; 0219-3108
DOI
10.1016/j.asjsur.2017.03.002
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COLLEGE OF MEDICINE[S](의과대학) > MEDICINE(의학과) > Articles
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