scholarly journals The Role of Prophylactic Central Neck Dissection in Differentiated Thyroid Carcinoma: Issues and Controversies

2011 ◽  
Vol 2011 ◽  
pp. 1-12 ◽  
Author(s):  
Kai-Pun Wong ◽  
Brian Hung-Hin Lang
Keyword(s):  
Thyroid Carcinoma ◽  
Total Thyroidectomy ◽  
Neck Dissection ◽  
Differentiated Thyroid Carcinoma ◽  
Central Neck Dissection ◽  
American Thyroid Association ◽  
Central Neck ◽  
Surgical Morbidity ◽  
Prophylactic Central Neck Dissection ◽  
Risk Patients

Prophylactic central neck dissection (pCND) in differentiated thyroid carcinoma (DTC) is one of the most controversial surgical subjects in recent times. To date, there is little evidence to support the practice of pCND in patients with DTC undergoing total thyroidectomy. Although the recently revised American Thyroid Association (ATA) guideline has clarified many inconsistencies regarding pCND and has recommended pCND in “high-risk” patients, many issues and controversies surrounding the subject of pCND in DTC remain. The recent literature has revealed an insignificant trend toward lower recurrence rate in patients with DTC who undergo total thyroidectomy and pCND than those who undergo total thyroidectomy alone. However, this was subjected to biases, and there are concerns whether pCND should be performed by all surgeons who manage DTC because of increased surgical morbodity. Performing a unilateral pCND may be better than a bilateral pCND given its lower surgical morbidity. Further studies in this controversial subject are much needed.

Effect of central compartment neck dissection on hypocalcaemia incidence after total thyroidectomy for carcinoma

2010 ◽  
Vol 125 (5) ◽  
pp. 497-501 ◽  
Author(s):  
I Mitra ◽  
J R Nichani ◽  
B Yap ◽  
J J Homer
Keyword(s):  
Thyroid Carcinoma ◽  
Total Thyroidectomy ◽  
Neck Dissection ◽  
Survival Benefit ◽  
Central Compartment ◽  
Differentiated Thyroid Carcinoma ◽  
Central Neck Dissection ◽  
Elective Neck Dissection ◽  
Central Neck ◽  
High Expectation

AbstractIntroduction:Central compartment neck dissection is increasingly performed as part of surgical management of differentiated thyroid carcinoma. However, elective central neck dissection remains controversial due to complications and lack of evidence of survival benefit.Objective:To investigate and compare rates of transient and permanent hypocalcaemia following total thyroidectomy alone, compared with total thyroidectomy with central neck dissection, for differentiated thyroid carcinoma.Methods:Retrospective study of 127 consecutive patients referred with differentiated thyroid carcinoma, 2004–2006; 78 patients had undergone total thyroidectomy (group one) and 49 total thyroidectomy with central compartment node dissection (group two). Surgery was performed in various hospitals by both otolaryngologists and endocrine surgeons.Results:In groups one and two, the incidence of transient hypocalcaemia was 18 per cent (14/78) and 51 per cent (25/49) (p < 0.001), and the incidence of permanent hypocalcaemia 1 per cent (one of 77) and 12 per cent (six of 49) (p < 0.01), respectively. Most patients undergoing central neck dissection had evidence of pathological level six lymphadenopathy (29/49).Conclusion:Total thyroidectomy combined with central neck dissection for the treatment of differentiated thyroid carcinoma is more likely to result in transient (51 per cent) and permanent (12 per cent) hypocalcaemia. Elective neck dissection should be performed selectively, with a high expectation of post-operative hypocalcaemia.

scholarly journals The Benefits and Risks of Prophylactic Central Neck Dissection for Papillary Thyroid Carcinoma: Prospective Cohort Study

2015 ◽  
Vol 2015 ◽  
pp. 1-6 ◽  
Author(s):  
Doh Young Lee ◽  
Kyoung Ho Oh ◽  
Jae-Gu Cho ◽  
Soon-Young Kwon ◽  
Jeong-Soo Woo ◽  
...  
Keyword(s):  
Papillary Thyroid Carcinoma ◽  
Thyroid Carcinoma ◽  
Total Thyroidectomy ◽  
Neck Dissection ◽  
Disease Recurrence ◽  
Central Neck Dissection ◽  
Complication Rates ◽  
Central Neck ◽  
Papillary Thyroid ◽  
Prophylactic Central Neck Dissection

Objectives. This study evaluated the benefits of performing prophylactic central neck dissection (CND) with total thyroidectomy (TT) in management of papillary thyroid carcinoma (PTC) patients who were clinically node-negative at presentation.Methods.A total of 257 patients with stage T1 or T2 PTC and without preoperative evidence of lymph node involvement (N0) were enrolled in this prospective study. The patients were randomly assigned to two groups: (1) a total thyroidectomy (TT) group (n=104) or (2) a TT plus CND group (n=153). The two groups were compared for their perioperative data, complication rates, disease recurrence rates, and clinical outcomes.Results. The two groups of patients were similar in age, sex ratio, follow-up duration, and tumor size (P=0.227, 0.359, 0.214, and 0.878, resp.). The two groups showed similar rates of disease recurrence (3.9% in the TT group versus 3.3% in the TT plus CND group); however, complications occurred more frequently in the TT plus CND group; especially transient hypocalcemia (P=0.043).Conclusions.Patients treated with TT plus CND had a higher rate of complications with similar recurrence rate. We believe that CND may not be routinely recommended when treating patients with PTC.

scholarly journals Risks and Benefits of Central Neck Dissection (CND) in Differentiated Thyroid Carcinoma (DTC)

2020 ◽  
Vol 46 (1) ◽  
pp. 72-85
Author(s):  
H.S. Wahyu Purnomo ◽  
Erwin D Yulian ◽  
Grace Wangge
Keyword(s):  
Thyroid Carcinoma ◽  
Neck Dissection ◽  
Locoregional Recurrence ◽  
English Language ◽  
Differentiated Thyroid Carcinoma ◽  
Central Neck Dissection ◽  
Central Neck ◽  
Surgical Morbidity ◽  
Increased Risk ◽  
Risk And Benefit

Introduction: The role of central neck dissection (CND) remains controversial in differentiated thyroid cancer (DTC). Risk and benefit of CND is necessary to be identified for judging whether CND will be performed or not. Methods: A literature search was performed in MEDLINE (pubmed) using main keywords such as differentiated thyroid carcinoma (DTC), central neck dissection (CND), total thyroidectomy. The literature had inclusion criteria english language literature with risk and benefit of CND. We used qualitative approach to summary descriptive papers result. Results: Sixteen trials were analyzed. There was no increased risk of recurrent laryngeal nerve (RLN) injury (temporary or permanent), permanent hypocalcemia, or locoregional recurrence when CND was performed in addition to TT. Postoperative temporary hypocalcemia was more common after TT with CND than after TT alone. Conclusion: TT alone results in less surgical morbidity in the immediate postoperative period and an identical locoregional recurrence rate compared with TT plus CND.

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