Analysis of Treatment Results after Thyroid Lobectomy with Prophylactic Ipsilateral Central Neck Lymph Node Dissection for Low-Risk Papillary Thyroid Carcinoma: A Single Institute Experience.
10.3342/kjorl-hns.2015.58.11.769
- Author:
Joo Yul CHOI
1
;
Min Joo KIM
;
Ilhan LIM
;
Guk Haeng LEE
;
Byeong Cheol LEE
;
Ik Joon CHOI
;
Myung Chul LEE
Author Information
1. Department of Otorhinolaryngology-Head & Neck Surgery, Korea Cancer Center Hospital, Korea Institute of Radiological and Medical Sciences (KIRAMS), Seoul, Korea. lmc@daum.net
- Publication Type:Original Article
- Keywords:
Central lymph node dissection;
Lobectomy;
Papillary thyroid carcinoma;
Recurrence;
Thyroidectomy
- MeSH:
Follow-Up Studies;
Humans;
Lymph Node Excision*;
Lymph Nodes*;
Neck*;
Neoplasm Metastasis;
Recurrence;
Retrospective Studies;
Risk Factors;
Survival Rate;
Thyroid Gland*;
Thyroid Neoplasms*;
Thyroidectomy;
Vocal Cord Paralysis
- From:Korean Journal of Otolaryngology - Head and Neck Surgery
2015;58(11):769-775
- CountryRepublic of Korea
- Language:Korean
-
Abstract:
BACKGROUND AND OBJECTIVES: Surgical options for low-risk papillary thyroid carcinoma (PTC) have been in debate. The purpose of this study was to analyze the treatment results of lobectomy and prophylactic ipsilateral central lymph node dissection (cND) for low-risk PTC. SUBJECTS AND METHOD: We retrospectively analyzed 906 patients who were diagnosed as PTC pre- or post-operatively and underwent lobectomy and/or prophylactic ipsilateral cND from 2001 to 2010. Studied variables were clinicopathologic data, complications, sites of recurrence, overall survival, and recurrence free survival rates. RESULTS: Fifty two (5.7%) patients showed recurrence during follow-up. Of the 52 recurrent cases, 32 (61.5%) cases recurred in a remnant thyroid only, 11 (21.2%) cases in a lymph node (LN) only, and 9 (17.3%) cases in a remnant thyroid and the LN. One (0.1%) patient showed permanent vocal cord palsy. Overall survival rate at 10 years was 99.6%. Overall recurrence free survival rates at 5 and 10 years were 97.1% and 81.0%, respectively. Risk factors for recurrences were old age (>45), contralateral nodule(s) at initial surgery, large tumor, no prophylactic cND, and pathological LN metastasis. CONCLUSION: Lobectomy with prophylactic ipsilateral cND may be a good option for low risk PTC patients due to excellent overall survival rates, recurrence rates, and minimal complication rates.
