Central Lymph Node Dissection in Differentiated Thyroid Cancer

Abstract

Evidence-based recommendations support CLND for PTC in patients under the care of experienced endocrine surgeons.

Safety and Prognostic Impact of Prophylactic Level VII Lymph Node Dissection for Papillary Thyroid Carcinoma

“…In this study, the permanent hypoparathyroidism was documented in 6.5% for group A and 9.4% for group B patients which was much less than that reported by Tartaglia et al, 2014 25.4% of patients who underwent TT + CND, within the range reported by White et al, 20070-14.3% while Pereira et al, 2005Choi et al, 2011;Popadich et al,2011;Wang et al, 2013;and Lee et al, 2015 reported only 2%, 3% ,0.8%, 4.6% and 3.3% permanent hypoparathyroidism respectively. Temporary hypoparathyroidism was (Tartaglia et al, 2014), 6% (Wang et al, 2013) and 9.7% (Popadich et al, 2011) but sometimes as high as 60% (Pereira et al, 2005).…”

“…Putting in mind that pCND was advised by the European Thyroid Association, the British Thyroid Association, and the American Thyroid Association (Pacini et al, 2006;Grubbs et al, 2007) and its benefit in the accurate staging of the tumor, which may guide subsequent treatment and follow-up, in addition to decreasing the recurrence of PTC, improving disease-specific survival, and significantly reducing levels of serum thyroglobulin, increasing the rate of athyroglobulinemia (White et al, 2007) so pCND was done in all patients (including level VII in group A) of this study.…”

“…It should be remembered that the rate of permanent hypoparathyroidism and unintentional permanent nerve injury is higher when cervical lymph node dissection is performed with total thyroidectomy than with total thyroidectomy alone (White et al, 2007). In this study, the permanent hypoparathyroidism was documented in 6.5% for group A and 9.4% for group B patients which was much less than that reported by Tartaglia et al, 2014 25.4% of patients who underwent TT + CND, within the range reported by White et al, 20070-14.3% while Pereira et al, 2005Choi et al, 2011;Popadich et al,2011;Wang et al, 2013;and Lee et al, 2015 reported only 2%, 3% ,0.8%, 4.6% and 3.3% permanent hypoparathyroidism respectively.…”

Risk Factors for Nodal Metastasis in cN0 Papillary Thyroid Microcarcinoma

“…It has been generally accepted that the majority of PTMC patients has an excellent prognosis. However, this view has been challenged with new researches reporting increased local recurrence rates (White et al, 2007) and reduced survival with regional LNM (Hughes et al, 2010). For PTMC, cervical lymph node metastases are common, with an incidence between 30% and 60% (Hay et al, 2008;He et al, 2012).…”

Prophylactic Level VII Nodal Dissection as a Prognostic Factor in Papillary Thyroid Carcinoma: a Pilot Study of 27 Patients

“…For White et al, 2007 the rate of permanent hypoparathyroidism after total thyroidectomy (TT) with prophylactic CND is between 0% and 14.3%.…”