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World Journal of Surgery

, Volume 37, Issue 8, pp 1951–1958 | Cite as

Influence of Prophylactic Neck Dissection on Rate of Retreatment for Papillary Thyroid Carcinoma

  • Dana M. Hartl
  • Elisabeth Mamelle
  • Isabelle Borget
  • Sophie Leboulleux
  • Haïtham Mirghani
  • Martin Schlumberger
Article

Abstract

Background

Prophylactic neck dissection (PND) for papillary thyroid cancer is controversial. The objective of this study was to analyze the influence of PND on the rate of retreatment.

Methods

In this retrospective case-control study, papillary thyroid carcinomas >10 mm without ultrasonographic evidence of nodal disease (cN0) were treated with total thyroidectomy (TT) or TT with bilateral central compartment PND. All received postoperative radioactive iodine (131I) and were followed for at least 1 year. We compared the rate of retreatment (surgery or 131I).

Results

Altogether, 246 patients (mean age 46 years, 78 % women) underwent TT (n = 91) or TT + PND (n = 155). The groups were similar in age, sex, tumor size, and follow-up (median 6.3 years) (p > 0.05). Overall, 11 (12 %) of the patients in the TT group underwent reoperation in the central compartment for recurrence versus 3 (2 %) in the TT + PND group (p < 0.001). There were 1.18 administrations of 131I for the TT group versus 1.08 for the TT + PND group (p = 0.08). The average cumulative dose of 131I was 3.9 ± 1.8 GBq for the TT group and 3.8 ± 1.3 GBq for the TT + PND group (p = 0.52). Actuarial (Kaplan-Meier) 5-year retreatment rates were 14.7 % in the TT group and 6.5 % in the TT + PND group (p = 0.01, log-rank). The rate of permanent recurrent nerve paralysis was 2 % for the TT group and 1 % for the TT + PND group (p = 0.98). The rates of permanent hypoparathyroidism were 7 versus 3 %, respectively (p = 0.12).

Conclusions

Five-year retreatment rates were lower in patients treated with PND, with no added permanent morbidity.

Keywords

Papillary Thyroid Carcinoma Total Thyroidectomy Central Compartment Radioactive Iodine Lateral Neck 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.

Notes

Conflicts of interest

The authors have nothing to disclose.

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Copyright information

© Société Internationale de Chirurgie 2013

Authors and Affiliations

  • Dana M. Hartl
    • 1
  • Elisabeth Mamelle
    • 1
  • Isabelle Borget
    • 2
  • Sophie Leboulleux
    • 3
  • Haïtham Mirghani
    • 1
  • Martin Schlumberger
    • 3
  1. 1.Department of Head and Neck Oncology, Thyroid Surgery UnitInstitut Gustave Roussy and Paris-Sud UniversityVillejuif CedexFrance
  2. 2.Department of Clinical Research, Biostatistics and Epidemiology UnitInstitut Gustave Roussy and Paris-Sud UniversityVillejuifFrance
  3. 3.Department of Nuclear Medicine and Endocrine OncologyInstitut Gustave Roussy and Paris-Sud UniversityVillejuifFrance

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