The effects of prophylactic central cervical lymph nodes dissection in prevention of disease recurrence of patients with papillary thyroid carcinoma (PTC)

Papillary thyroid carcinoma (PTC), unlike other cancers, is completely curable if the treatment begins at early stages of the disease, before any metastasis occurs. One of the common places that the cancer may invade is the cervical lymph node. On this basis, many surgeons suggest prophylactic central cervical lymph nodes dissection in such patients, but others do not agree because of the risks that may exceed the benefits of this approach. Despite the presence of several studies in this regard, the debate is still ongoing. This study aims to examine the effect of prophylactic central cervical lymph node dissection in preventing recurrence in patients with PTC.
Methods & Materials: A total of 122 patients with PTC who were operated at Sina Hospital, Tabriz, were enrolled in this study. They were categorized in two equal 61-patient groups, with (case) and without (control) prophylactic central cervical lymph node dissection. Short-term (up to 10 days post-operation) and long-term (6 months post-operation) consequences were compared between the two groups. None of the patients had evidences of central cervical lymph node involvement before operation.
Both groups were comparable in terms of age (mean, 46.1 years in the case group, 45.8 years in the control group, p=0.91) and sex (10 males in the case group, 11 males in the control group, p=0.81). In the case group there were 16 patients (26.2%) with pathology-proven central cervical lymph node involvement. Serum calcium level dropped more significantly in the case group immediately after the surgery, but returned to a comparable level with that in the controls at the 6-month time-point. Comparing cases and controls showed no significant difference in terms of vocal cord involvement (4.9% vs. 3.3%, respectively; p=0.50), recurrent mass (0% vs. 3%, respectively; p=0.49) or new regional lymphadenopathy (1.6% vs. 7%, respectively; p=0.37). There were neither any deceased patient nor any patient with recurrent nerve injury in this study.
Prophylactic central cervical lymph node dissection has no significant effect on the occurrence rate of short-term/long-term complications of surgery in patients with PTC.