Central neck lymph node dissection for papillary thyroid cancer

Abstract

Relevance. Papillary thyroid cancer is often associated with regional metastases to lymph nodes including those of the central adipose tissue of the neck and the deep jugular lymph nodes. Assessment of metastatic involvement of the paratracheal lymph nodes in patients with well-differentiated thyroid cancer T1 and T2 is known to often produce false negative results. Surgical procedures in this region are technically challenging and associated with a certain risk of complications. Therefore, prophylactic removal of the central adipose tissue prevents local cancer recurrence and further metastatic involvement of the regional lymph nodes; moreover, it contributes to proper disease staging and planning of further patient management. Study goal. Was to determine the optimal extent of surgery for papillary thyroid cancer. Materials and methods. Sixty patients who underwent surgical procedures for papillary thyroid cancer were enrolled in the study. The study was carried out at SBHI Moscow Clinical Scientific Center named after A.S. Loginov of Moscow City Department of Healthcare from 2015 to 2017. Results. Regional metastases to the lymph nodes of the central adipose tissue of the neck removed during prophylactic central cervical lymph node dissection were revealed in 41.5% of cases. None of the patients demonstrated regional or distant metastases within 18 months of follow-up. Conclusions. Papillary thyroid cancer is associated with high incidence of regional metastases to the lymph nodes of the central adipose tissue of the neck, which necessitates central ipsilateral lymph node dissection simultaneously with thyroidectomy, which does not increase the postoperative complication rate.