Role of prophylactic central neck dissection in cN0-papillary thyroid carcinoma: Results from a high-prevalence area

Sebastiano Bonventre, Giuseppe Modica, Gaspare Gulotta, Cristina Raspanti, Silvia Di Giovanni, Angela Inviati, Andrea Attard, Giuseppina Irene Melfa, Gregorio Scerrino, Sebastiano Bonventre, Gaspare Gulotta, Giuseppe Modica, Marco Attard, Andrea Attard, Angela Inviati, Cristina Raspanti, Giuseppina Irene Melfa, Sergio Mazzola, Silvia Di Giovanni

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9 Citazioni (Scopus)

Abstract

BACKGROUND: Prophylactic, compartment-oriented central neck dissection (CND) for cN0 papillary thyroid carcinoma (PTC) is not widely practiced. We examined our results with this surgical approach. METHODS: A cohort of 158 patients operated on for the classical variant of PTC at a follow-up of 1-22 years (mean: 6.6) were enrolled. The patients with a preoperative diagnosis of cN0 PTC (group A, 59 patients) underwent total thyroidectomy (TT) + CND. In the patients with incidental postoperative diagnosis of malignancy (group B, 99 patients) a TT alone was performed. RESULTS: Ninety-six T1, 36 T2, 26 T3/T4 PTC patients were enrolled. The overall biochemical/scintigraphic recurrence rate (15 patients, 9.49%), was significantly higher in group B. Disease-free survival and need for postoperative radioiodine ablative treatment were more favorable in group A (P<0.05; P<0.001, respectively). The median radioiodine ablative treatment in the T2 cluster alone was lower in group A (P<0.001). The morbidity rate was similar in both groups. CONCLUSION: Considering the acceptable morbidity, prophylactic CND seems to be advantageous in terms of recurrence rate and need for radioiodine treatment in this variant of PTC, at least in T2 or more advanced stages. The indolent behavior of PTC does not allow for reliable prognostic evaluations.
Lingua originaleEnglish
pagine (da-a)159-167
Numero di pagine9
RivistaMinerva Chirurgica
Volume71
Stato di pubblicazionePublished - 2016

All Science Journal Classification (ASJC) codes

  • Surgery

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    Bonventre, S., Modica, G., Gulotta, G., Raspanti, C., Di Giovanni, S., Inviati, A., Attard, A., Melfa, G. I., Scerrino, G., Bonventre, S., Gulotta, G., Modica, G., Attard, M., Attard, A., Inviati, A., Raspanti, C., Melfa, G. I., Mazzola, S., & Di Giovanni, S. (2016). Role of prophylactic central neck dissection in cN0-papillary thyroid carcinoma: Results from a high-prevalence area. Minerva Chirurgica, 71, 159-167.