Thyroidectomy without lateral neck dissection for papillary thyroid carcinoma with lateral neck lymph node metastases and negative intraoperative frozen section

Head Neck. 2016 Feb;38(2):285-9. doi: 10.1002/hed.23893. Epub 2015 Jul 29.

Abstract

Background: The purpose of this study was to investigate the outcomes of patients with papillary thyroid cancer (PTC) with lateral neck metastasis according to their permanent pathology report but negative frozen section findings who did not undergo lateral neck dissection.

Methods: Between September 2009 and December 2011, 575 patients at Gangnam Severance Hospital (Seoul, Korea) underwent frozen section analysis for a suspicious lateral neck lymph node. In 16 patients, the intraoperative findings were negative, but lateral neck metastasis was diagnosed on the basis of permanent pathology findings. The outcomes of these patients who underwent thyroidectomy but not lateral neck dissection were retrospectively investigated.

Results: One patient underwent a subsequent lateral neck dissection. After a mean (SD) follow-up period of 42.1 (8.5) months, none of the patients had distant metastasis.

Conclusion: Total thyroidectomy with subsequent lateral neck dissection is not necessary in patients with PTC who are diagnosed with lateral neck metastasis according to their permanent pathology report but have negative intraoperative frozen section findings.

Keywords: cervical; frozen sections; lymph node; metastasis; papillary thyroid carcinoma.

MeSH terms

  • Adult
  • Aged
  • Carcinoma, Papillary / pathology*
  • Carcinoma, Papillary / surgery*
  • Female
  • Follow-Up Studies
  • Frozen Sections*
  • Humans
  • Intraoperative Care
  • Lymph Nodes / pathology
  • Lymphatic Metastasis
  • Male
  • Middle Aged
  • Retrospective Studies
  • Thyroid Neoplasms / pathology*
  • Thyroid Neoplasms / surgery*
  • Thyroidectomy*