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Significance of prophylactic modified radical neck dissection for patients with low-risk papillary thyroid carcinoma measuring 1.1–3.0 cm: First report of a trial at Kuma Hospital

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Abstract

Purpose

Papillary thyroid carcinoma (PTC) frequently metastasizes to and recurs in regional lymph nodes. Of the two compartments, the central compartment can be dissected through the same wound as the thyroidectomy, and the central node dissection (CND) is routinely performed in most Japanese surgical departments. However, the indications for prophylactic lateral compartment dissection (modified radical neck dissection [MND]) for low-risk PTC remain unclear. In this study, we investigated the indications for prophylactic MND for PTC patients with tumor measuring 1.1–3.0 cm without significant extrathyroid extension or distant metastasis.

Methods

We investigated the lymph node disease-free survival (LN-DFS) rates of 829 patients who underwent CND and of 414 patients who underwent MND and CND between 2005 and 2007 at Kuma Hospital.

Results

The LN-DFS of these two groups was not significantly different. In the subset of patients with CND only, clinical central node metastasis (N1a) significantly predicted a worse LN-DFS. All N1a patients recognized as showing recurrence developed such recurrence in the lateral compartment. Other conventional prognostic factors, such as sex and age, were not related to LN-DFS.

Conclusion

Taken together, N1a patients with low-risk PTC measuring 1.1–3.0 cm can be considered as candidates for prophylactic MND.

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Authors and Affiliations

  1. Department of Surgery, Kuma Hospital, 8-2-35 Shimoyamate-dori, Chuo-ku, Kobe, 650-0011, Japan

    Yasuhiro Ito, Yukiko Tsushima, Hiroo Masuoka, Tomonori Yabuta, Mitsuhiro Fukushima, Hiroyuki Inoue, Chisato Tomoda, Minoru Kihara, Takuya Higashiyama, Yuuki Takamura, Kaoru Kobayashi, Akihiro Miya & Akira Miyauchi

Authors
  1. Yasuhiro Ito
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  2. Yukiko Tsushima
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  3. Hiroo Masuoka
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  4. Tomonori Yabuta
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  5. Mitsuhiro Fukushima
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  6. Hiroyuki Inoue
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  7. Chisato Tomoda
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  8. Minoru Kihara
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  9. Takuya Higashiyama
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  10. Yuuki Takamura
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  11. Kaoru Kobayashi
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  12. Akihiro Miya
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  13. Akira Miyauchi
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Ito, Y., Tsushima, Y., Masuoka, H. et al. Significance of prophylactic modified radical neck dissection for patients with low-risk papillary thyroid carcinoma measuring 1.1–3.0 cm: First report of a trial at Kuma Hospital. Surg Today 41, 1486–1491 (2011). https://doi.org/10.1007/s00595-010-4494-7

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  • DOI: https://doi.org/10.1007/s00595-010-4494-7

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