TY - JOUR
T1 - Influence of prophylactic neck dissection on rate of retreatment for papillary thyroid carcinoma
AU - Hartl, Dana M.
AU - Mamelle, Elisabeth
AU - Borget, Isabelle
AU - Leboulleux, Sophie
AU - Mirghani, Haïtham
AU - Schlumberger, Martin
PY - 2013/8/1
Y1 - 2013/8/1
N2 - Background: Prophylactic neck dissection (PND) for papillary thyroid cancer is controversial. The objective of this study was to analyze the influence of PND on the rate of retreatment. Methods: In this retrospective case-control study, papillary thyroid carcinomas >10 mm without ultrasonographic evidence of nodal disease (cN0) were treated with total thyroidectomy (TT) or TT with bilateral central compartment PND. All received postoperative radioactive iodine (131I) and were followed for at least 1 year. We compared the rate of retreatment (surgery or 131I). Results: Altogether, 246 patients (mean age 46 years, 78 % women) underwent TT (n = 91) or TT + PND (n = 155). The groups were similar in age, sex, tumor size, and follow-up (median 6.3 years) (p > 0.05). Overall, 11 (12 %) of the patients in the TT group underwent reoperation in the central compartment for recurrence versus 3 (2 %) in the TT + PND group (p < 0.001). There were 1.18 administrations of 131I for the TT group versus 1.08 for the TT + PND group (p = 0.08). The average cumulative dose of 131I was 3.9 ± 1.8 GBq for the TT group and 3.8 ± 1.3 GBq for the TT + PND group (p = 0.52). Actuarial (Kaplan-Meier) 5-year retreatment rates were 14.7 % in the TT group and 6.5 % in the TT + PND group (p = 0.01, log-rank). The rate of permanent recurrent nerve paralysis was 2 % for the TT group and 1 % for the TT + PND group (p = 0.98). The rates of permanent hypoparathyroidism were 7 versus 3 %, respectively (p = 0.12). Conclusions: Five-year retreatment rates were lower in patients treated with PND, with no added permanent morbidity.
AB - Background: Prophylactic neck dissection (PND) for papillary thyroid cancer is controversial. The objective of this study was to analyze the influence of PND on the rate of retreatment. Methods: In this retrospective case-control study, papillary thyroid carcinomas >10 mm without ultrasonographic evidence of nodal disease (cN0) were treated with total thyroidectomy (TT) or TT with bilateral central compartment PND. All received postoperative radioactive iodine (131I) and were followed for at least 1 year. We compared the rate of retreatment (surgery or 131I). Results: Altogether, 246 patients (mean age 46 years, 78 % women) underwent TT (n = 91) or TT + PND (n = 155). The groups were similar in age, sex, tumor size, and follow-up (median 6.3 years) (p > 0.05). Overall, 11 (12 %) of the patients in the TT group underwent reoperation in the central compartment for recurrence versus 3 (2 %) in the TT + PND group (p < 0.001). There were 1.18 administrations of 131I for the TT group versus 1.08 for the TT + PND group (p = 0.08). The average cumulative dose of 131I was 3.9 ± 1.8 GBq for the TT group and 3.8 ± 1.3 GBq for the TT + PND group (p = 0.52). Actuarial (Kaplan-Meier) 5-year retreatment rates were 14.7 % in the TT group and 6.5 % in the TT + PND group (p = 0.01, log-rank). The rate of permanent recurrent nerve paralysis was 2 % for the TT group and 1 % for the TT + PND group (p = 0.98). The rates of permanent hypoparathyroidism were 7 versus 3 %, respectively (p = 0.12). Conclusions: Five-year retreatment rates were lower in patients treated with PND, with no added permanent morbidity.
UR - http://www.scopus.com/inward/record.url?scp=84880843037&partnerID=8YFLogxK
U2 - 10.1007/s00268-013-2089-3
DO - 10.1007/s00268-013-2089-3
M3 - Article
C2 - 23677562
AN - SCOPUS:84880843037
SN - 0364-2313
VL - 37
SP - 1951
EP - 1958
JO - World Journal of Surgery
JF - World Journal of Surgery
IS - 8
ER -