Efficacy of prophylactic central neck dissection in hemithyroidectomy for papillary thyroid carcinoma

Eur Arch Otorhinolaryngol. 2020 Mar;277(3):873-879. doi: 10.1007/s00405-019-05744-7. Epub 2019 Dec 2.

Abstract

Purpose: To evaluate the efficacy of prophylactic central neck dissection (pCND) in hemithyroidectomy for clinically node-negative papillary thyroid carcinoma (PTC).

Methods: We retrospectively analyzed 299 patients who underwent thyroid lobectomy with or without pCND for unilateral PTC. Of the 299 patients, 245 (81.9%) underwent unilateral pCND along with lobectomy, and 54 (18.1%) patients underwent lobectomy without pCND. Propensity score matching was performed for five covariates to reduce selection bias.

Results: In the baseline cohort of 299 patients, mean age, extrathyroidal extension, T classification and stage were higher in the cases undergoing pCND than in those not undergoing pCND. After propensity score matching, the significant differences between the two groups seen in the baseline cohort disappeared. Recurrence rates and recurrence-free survival curves did not differ between the 2 matched groups each of 54 patients.

Conclusion: The value of pCND in hemithyroidectomy for PTC is limited.

Keywords: Hemithyroidectomy; Papillary thyroid carcinoma; Propensity score matching; Prophylactic central neck dissection; Thyroid lobectomy.

MeSH terms

  • Carcinoma, Papillary* / surgery
  • Humans
  • Neck Dissection
  • Neoplasm Recurrence, Local
  • Retrospective Studies
  • Thyroid Cancer, Papillary / surgery
  • Thyroid Neoplasms* / surgery
  • Thyroidectomy