The treatment of papillary thyroid carcinoma located in the isthmus

Abstract

Objective To investigate the treatment for papillary thyroid carcinoma(PTC)located in the isthmus. Methods 90 patients with PTC located in the isthmus receiving surgery from May 2007 to Dec. 2013 were enrolled. Patients' age, multifocality, capsular invasion, central compartment lymph node metastasis were analyzed and compared with the results of 82 patients who had PTC within the thyroid lobe. Results In patients with PTC located in the isthmus, those with multi foci were older((49.4±9.9)years, P=0.004). Patients with capsular invasion had larger tumor((1.02±0.43)cm, P=0.001). Compared with PTC within the lobe, PTC located in isthmus were more likely to be multifocal(27.8% vs 14.6%, P=0.036)and capsular invasive(42.2% vs.19.5%, P=0.001). Central compartment lymph nodes metastasis rate was higher in patients with PTC located in isthmus but no statistical difference was found(53.3% vs 48.8%, P=0.551). Conclusions PTC located in the isthmus tends to be more aggressive at early stage. Central compartment lymph node metastasis occurs early and can be on both sides. Most patients should receive total thyroidectomy and central compartment lymph node dissection of both sides, but there's no need to dissect lymph node beneath the recurrent laryngeal nerve on the contralateral central compartment. Key words: Papillary thyroid carcinoma; Isthmus; Surgery