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Surgery. 2009 Dec;146(6):1188-95. doi: 10.1016/j.surg.2009.09.014.

The long term outcome of papillary thyroid carcinoma patients without primary central lymph node dissection: expected improvement of routine dissection.

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  • 1Department of General Surgery, Istanbul Medical Faculty, Istanbul, Turkey. ygiles@superonline.com

Abstract

BACKGROUND:

We investigated central compartment recurrence (CCR) and mortality rate in patients with papillary thyroid carcinoma (PTC) who had no central lymph node dissection (CLND) at the time of primary operation.

METHODS:

The medical records of 343 patients who underwent operations for PTC between January 1988 and December 2002 with a mean postoperative follow-up period of 9 +/- 4 years, were reviewed.

RESULTS:

Twenty-two patients (6%) had locoregional recurrence. The lateral, central, or both compartments were involved in 16, 2, and 4 of 22 patients, respectively. The rate of CCR was 2% (6/343). Five (2%) patients died from PTC due to locoregional invasion (tracheal and esophageal invasion) in 3 patients and distant metastasis in 2 patients. Older age (>or=60), initial metastatic lateral cervical lymph nodes, size of primary tumor size >or=3 cm, microscopic extrathyroidial extension, and aggressive histologic subtypes (diffuse sclerosing, tall-cell, poorly differentiated) of PTC were risk factors for CCR and mortality (P = .0001).

CONCLUSION:

Initial CLND might be of value to prevent CCR and mortality in PTC patients with initial metastatic cervical lateral lymph nodes, older age (age >or=60), primary tumor size >or=3 cm, and agressive histopathologic features of PTC.

PMID:
19958948
[PubMed - indexed for MEDLINE]
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