Prophylactic central lymph node dissection for patients of cN0 thyroid papillary carcinoma
10.3760/cma.j.issn.1007-631X.2017.03.005
- VernacularTitle:甲状腺乳头状癌cN0患者预防性中央区淋巴结清扫的意义及范围探讨
- Author:
An QIN
;
Xiao LIU
;
Guanglin ZHANG
;
Chunqiang CHU
- Keywords:
Thyroid neoplasms;
Carcinoma;
papillary;
Lymphatic metastasis;
Neck dissection
- From:
Chinese Journal of General Surgery
2017;32(3):202-206
- CountryChina
- Language:Chinese
-
Abstract:
Objective To explore central lymph node metastasis (CLNM) of cN0 papillary thyroid carcinoma(PTC).Methods We evaluate the clinical data of 245 patients with cN0 unilateral TPC undergoing total thyroidectomy and bilateral central lymph node dissection.Results Central lymph node metastasis of cN0 TPC was 36.8％ (91/245),significantly related to gender(x2 =5.626,P =0.018),age (x2 =6.255,P =0.012),tumor size (x2 =20.063,P ＜ 0.001) and capsule invasion (x2 =15.024,P ＜ 0.001).The central lymph node metastasis was 51.7％ (60/116) in 116 patients with tumor size ＞ 1 cm,and the contralateral CLNM was 22.4％ (26/116) which was related to capsule invasion (x2 =9.737,P =0.002) and delphian LNM(x2 =10.982,P =0.001) There were 6 cases (2.4％) suffering from temporary unilateral recurrent laryngeal nerve injury.96 cases (39.2％) suffered from temporary hypoparathyroidism and 3 cases (1.2％) from permanent hypoparathyroidism.The median follow-up time was 40 months.6 cases were found regional lymph node recurrence on the ipsilateral side.Tumor size ＞ 1 cm was significantly related with recurrence (P =0.008),as CLNM with higher recurrence rate (P =0.001).Conclusions CLNM is common in cN0 PTC patients,and central lymph node metastases increase the risk of recurrence.Prophylactic bilateral central lymph node dissection is suggested for tumor size ＞ 1 cm cases.
