The Evaluation of Routine Central Nodal Dissection in Radiologically Node Negative Differentiated Thyroid Carcinoma

Abstract

Background: thyroid cancer is the most common malignant disease in endocrine system and is rapidly increasing in incidence. The use of routine prophylactic central neck dissection for the treatment of differentiated thyroid cancer has been an area of debate over the past few decades. Aim of the Work: the primary aim of surgery was to resect disease, minimize the chance of recurrence and achieve this with minimal morbidity. Selecting the appropriate procedure is critical as not only does surgery provide initial therapy, but also optimizes the patient for adjuvant radioactive iodine (RAI) therapy when required. Patients and Methods: this study was conducted to evaluate the efficacy of prophylactic central lymph nodal dissection in patients diagnosed with differentiated thyroid carcinoma from several points of view including operative time, hospital stay, postoperative complications and most importantly the recurrence. Our patients were operated upon between August 2016 and August 2017 with minimal follow up of 6 months and follow up extended to 2 years after surgery. Results: Operative time was significantly higher in group B with a mean time of 141.68 ± 12.72 as compared to group A. The most outstanding difference in terms of complications was detected in transient hypoparathyroidism that occurred in 16% of group B patients. A single case of recurrence was detected at 12 month in group A that was confirmed by fine needle aspiration cytology which required reoperation. Conclusion: there was no convincing evidence that pCND leads to an improvement in recurrence rate, overall survival, or any clinically significant variable when applied indiscriminately to DTC patients.