Factors affecting the adequacy of lymph node yield in prophylactic unilateral central neck dissection for papillary thyroid carcinoma
Article first published online: 20 JUN 2012
Copyright © 2012 Wiley Periodicals, Inc.
Journal of Surgical Oncology
Volume 106, Issue 8, pages 966–971, 15 December 2012
How to Cite
Lang, B. H.-H., Yih, P. C.-L., Shek, T. W.-H., Wan, K. Y., Wong, K. P. and Lo, C.-Y. (2012), Factors affecting the adequacy of lymph node yield in prophylactic unilateral central neck dissection for papillary thyroid carcinoma. J. Surg. Oncol., 106: 966–971. doi: 10.1002/jso.23201
- Issue published online: 14 NOV 2012
- Article first published online: 20 JUN 2012
- Manuscript Accepted: 30 MAY 2012
- Manuscript Received: 3 APR 2012
- thyroid carcinoma;
- neck dissection;
- lymph node yield;
- lymph node metastasis
Determinants for adequate lymph node yield (LNY) in prophylactic central neck dissection (pCND) for papillary thyroid carcinoma (PTC) remain unclear. We aimed to determine factors affecting LNY in pCND.
Of 230 patients, 109 (47.4%) had total thyroidectomy and unilateral pCND. A specimen of ≥6 central lymph nodes (CLNs) was considered adequate. Factors such as patient clinicopathologic features, specimen dimensions, and pathologists' experience were compared between those with LNY < 6 (n = 52) and LNY ≥ 6 (n = 57). A multivariate analysis was conducted to identify independent factors for LNY ≥ 6.
Age, sex, presentation, body mass index, tumor characteristics, TNM stages, MACIS score, and pathologist's experience were not significant determinants for LNY ≥ 6. In the univariate analysis, the length (P = 0.021), width (P = 0.047), thickness (P = 0.024), and pN1a (P = 0.042) were significant determinants but in the multivariate analysis, the length (OR = 1.486 (95% CI: 1.053–2.097), P = 0.024) was the only independent factor for LNY ≥ 6. Postoperative vocal cord palsy, hypoparathyroidism, stimulated thyroglobulin and recurrences were similar between LNY <6 and ≥6.
Length (or the longest measured dimension) of the fresh CLN specimen was the only factor assuring LNY ≥ 6. Surgical complications and short-term outcomes appeared similar between LNY <6 or ≥6. J. Surg. Oncol. 2012; 106: 966–971. © 2012 Wiley Periodicals, Inc.