Investigation of selective neck dissection for differentiated thyroid cancer

Abstract

To investigate the indication, operative method and results of selective neck dissection (SND) for differentiated thyroid cancer. According to the level system and the operative guideline of the American Head and Neck Society, 40 cases of thyroid cancer (phase I: 35 cases, phase II: 2 cases, phase III: 3 cases) were collected prospectively. Thyroidectomy plus SND was performed on all the cases. And the indication, operative methods and results were investigated. Nine of the 40 cases received level VI dissection only. Twenty-four of the 40 cases received SND with levels </= 3 by a simple transverse incision on the neck. The overall lymph nodes positive rate was 67% (28/42). The positive rates of VI, IV, III, II and V levels were 58% (23/40), 48% (16/33), 48% (14/29), 50% (7/14) and 27% (4/15) respectively. The positive rate of level VI was not significantly higher than those of the level IV, III and II (P > 0.05). One parathyroid was found in 20% (8/40) of the specimen and 27% (11/40) of the patients had transient hypocalcemia, but no permanent hypocalcemia. Three (7.5%) of the patients had vocal cord paralysis for a short period of time and no permanent case was detected. Nineteen patients were followed up for more than 6 months after the operation and no enlarged neck lymph node was found by ultrasound at the 6th month postoperatively. It is reasonable to give SND to the early thyroid cancer patients.