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Central lymph node dissection as a secondary procedure for papillary thyroid cancer
Surgery, 04/21/09

Alvarado R et al. - In a study to compare the clinical outcomes in pts with papillary thyroid cancer (PTC) who underwent central lymph node dissection (CLND) as a secondary event with those having initial CLND, it was shown that there is no additional morbidity when CLND is performed as a secondary procedure for pts with PTC. Secondary CLND should be performed in pts with proven central compartment metastatic disease after previous thyroidectomy and can be offered safely as a prophylactic procedure to pts at high risk for central lymph node metastasis when CLND has not been performed at initial primary operation for PTC.

• A study of 193 pts who underwent CLND for PTC was undertaken.
• Data gathered included pt demographics, number of lymph nodes excised, lymph node involvement, and incidence of postoperative complications.

• 170 (M/F: 28/142) pts (Grp A) had a CLND as part of their primary surgical procedure while 23 (M/F: 10/13) pts (Grp B) underwent CLND as a secondary procedure (12 therapeutic/11 prophylactic procedures).
• Mean number of lymph nodes sampled and percent involved in the 2 groups A and B were 9.2 vs 10.2 and 64% vs 61%, respectively.
• Incidence of temporary hypocalcemia (12% vs 9%), permanent hypoparathyroidism (1.8% vs 0%), temporary recurrent laryngeal nerve (RLN) paresis (3% vs 4%), permanent RLN paresis (0.6% vs 0%), and wound infection (0.6% vs 4.3%) was comparable in groups A and B.

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