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Impact of Routine Unilateral Central Neck Dissection on Preablative and Postablative Stimulated Thyroglobulin Levels after Total Thyroidectomy in Papillary Thyroid Carcinoma

2012; Springer Science+Business Media; Volume: 3; Issue: 3 Linguagem: Inglês

10.1007/s13193-012-0156-0

0976-6952

Brian Hung‐Hin Lang, Kai Pun Wong, Koon Yat Wan, Chung Yau Lo,

Head and Neck Anomalies

Background.Prophylactic central neck dissection (CND) remains controversial in papillary thyroid carcinoma (PTC).Because postsurgical stimulated thyroglobulin (sTg) level is a good surrogate for recurrence, the study aimed to evaluate the impact of prophylactic CND on preablative and postablative sTg levels after total thyroidectomy.Methods.Of the 185 patients retrospectively analyzed, 82 (44.3%) underwent a total thyroidectomy and prophylactic CND (CND-positive group) while 103 (55.7%) underwent total thyroidectomy only (CND-negative group).All patients had no preoperative or intraoperative evidence of lymph node metastases.Clinicopathological characteristics, postoperative outcomes, and preablative and postablative sTg levels were compared between the two groups.Preablative sTg level was taken at the time of radioiodine ablation, while postablative sTg level was taken 6 months after ablation.A multivariable analysis was conducted to identify factors for preablative athyroglobulinemia (sTg \ 0.5 lg/L).Results.Relative to the CND-negative group, the CNDpositive group had larger tumors (15 mm vs. 10 mm, P \ 0.005), more extrathyroidal extension (26.8% vs. 14.6%,P \ 0.003), more tumor, node, metastasis system stage III disease (32.9% vs. 9.7%, P \ 0.001), and more temporary hypoparathyroidism (18.3% vs. 8.7%, P = 0.017).Fourteen patients (17.1%) in the CND-positive group were upstaged from stages I/II to III as a result of prophylactic CND.The CND-positive group experienced lower