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      Analysis of Treatment Results after Thyroid Lobectomy with Prophylactic Ipsilateral Central Neck Lymph Node Dissection for Low-Risk Papillary Thyroid Carcinoma: A Single Institute Experience

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      https://www.riss.kr/link?id=A101611042

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      Background and Objectives Surgical options for low-risk papillary thyroid carcinoma (PTC) have been in debate. The purpose of this study was to analyze the treatment results of lobectomy and prophylactic ipsilateral central lymph node dissection (cND)...

      Background and Objectives Surgical options for low-risk papillary thyroid carcinoma (PTC) have been in debate. The purpose of this study was to analyze the treatment results of lobectomy and prophylactic ipsilateral central lymph node dissection (cND) for low-risk PTC.
      Subjects and Method We retrospectively analyzed 906 patients who were diagnosed as PTC pre- or post-operatively and underwent lobectomy and/or prophylactic ipsilateral cND from 2001 to 2010. Studied variables were clinicopathologic data, complications, sites of recurrence, overall survival, and recurrence free survival rates.
      Results Fifty two (5.7%) patients showed recurrence during follow-up. Of the 52 recurrent cases, 32 (61.5%) cases recurred in a remnant thyroid only, 11 (21.2%) cases in a lymph node (LN) only, and 9 (17.3%) cases in a remnant thyroid and the LN. One (0.1%) patient showed permanent vocal cord palsy. Overall survival rate at 10 years was 99.6%. Overall recurrence free survival rates at 5 and 10 years were 97.1% and 81.0%, respectively. Risk factors for recurrences were old age (>45), contralateral nodule(s) at initial surgery, large tumor, no prophylactic cND, and pathological LN metastasis.
      Conclusion Lobectomy with prophylactic ipsilateral cND may be a good option for low risk PTC patients due to excellent overall survival rates, recurrence rates, and minimal complication rates.

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      참고문헌 (Reference) 논문관계도

      1 Hay ID, "Unilateral total lobectomy: is it sufficient surgical treatment for patients with AMES low-risk papillary thyroid carcinoma?" 124 (124): 958-964, 1998

      2 Kebebew E, "Total thyroidectomy or thyroid lobectomy in patients with low-risk differentiated thyroid cancer:surgical decision analysis of a controversy using a mathematical model" 24 (24): 1295-1302, 2000

      3 Nixon IJ, "Thyroid lobectomy for treatment of well differentiated intrathyroid malignancy" 151 (151): 571-579, 2012

      4 Matsuzu K, "Thyroid lobectomy for papillary thyroid cancer: longterm follow-up study of 1,088 cases" 38 (38): 68-79, 2014

      5 Sosa JA, "The importance of surgeon experience for clinical and economic outcomes from thyroidectomy" 228 (228): 320-330, 1998

      6 Chisholm EJ, "Systematic review and metaanalysis of the adverse effects of thyroidectomy combined with central neck dissection as compared with thyroidectomy alone" 119 (119): 1135-1139, 2009

      7 American Thyroid Association (ATA) Guidelines Taskforce on Thyroid Nodules and Differentiated Thyroid Cancer, "Revised American Thyroid Association management guidelines for patients with thyroid nodules and differentiated thyroid cancer" 19 (19): 1167-1214, 2009

      8 Dean DS, "Prognostic indicators in differentiated thyroid carcinoma" 7 (7): 229-239, 2000

      9 Caron NR, "Papillary thyroid cancer" 7 (7): 309-319, 2006

      10 Udelsman R, "Optimal surgery for papillary thyroid carcinoma" 20 (20): 88-93, 1996

      1 Hay ID, "Unilateral total lobectomy: is it sufficient surgical treatment for patients with AMES low-risk papillary thyroid carcinoma?" 124 (124): 958-964, 1998

      2 Kebebew E, "Total thyroidectomy or thyroid lobectomy in patients with low-risk differentiated thyroid cancer:surgical decision analysis of a controversy using a mathematical model" 24 (24): 1295-1302, 2000

      3 Nixon IJ, "Thyroid lobectomy for treatment of well differentiated intrathyroid malignancy" 151 (151): 571-579, 2012

      4 Matsuzu K, "Thyroid lobectomy for papillary thyroid cancer: longterm follow-up study of 1,088 cases" 38 (38): 68-79, 2014

      5 Sosa JA, "The importance of surgeon experience for clinical and economic outcomes from thyroidectomy" 228 (228): 320-330, 1998

      6 Chisholm EJ, "Systematic review and metaanalysis of the adverse effects of thyroidectomy combined with central neck dissection as compared with thyroidectomy alone" 119 (119): 1135-1139, 2009

      7 American Thyroid Association (ATA) Guidelines Taskforce on Thyroid Nodules and Differentiated Thyroid Cancer, "Revised American Thyroid Association management guidelines for patients with thyroid nodules and differentiated thyroid cancer" 19 (19): 1167-1214, 2009

      8 Dean DS, "Prognostic indicators in differentiated thyroid carcinoma" 7 (7): 229-239, 2000

      9 Caron NR, "Papillary thyroid cancer" 7 (7): 309-319, 2006

      10 Udelsman R, "Optimal surgery for papillary thyroid carcinoma" 20 (20): 88-93, 1996

      11 Attie JN, "Modified neck dissection in treatment of thyroid cancer: a safe procedure" 24 (24): 315-324, 1988

      12 Chen AY, "Increasing incidence of differentiated thyroid cancer in the United States, 1988-2005" 115 (115): 3801-3807, 2009

      13 Hyun SM, "Impact of combined prophylactic unilateral central neck dissection and hemithyroidectomy in patients with papillary thyroid microcarcinoma" 19 (19): 591-596, 2012

      14 Pacini F, "European consensus for the management of patients with differentiated thyroid carcinoma of the follicular epithelium" 154 (154): 787-803, 2006

      15 McLeod DS, "Controversies in primary treatment of low-risk papillary thyroid cancer" 381 (381): 1046-1057, 2013

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