Authors: Chang Wook Lee Gyungyup Gong JongLyel Roh
Publish Date: 2014/09/19
Volume: 39, Issue: 1, Pages: 194-202
Abstract
Although lymph node LN metastasis LNM of papillary thyroid carcinoma PTC is common routine prophylactic LN dissection LND is still controversial The purpose of this study was to investigate risk factors for recurrence of PTC with clinically nodenegative lateral neck to determine the utility of intraoperative LN biopsyThis study involved 185 patients with pathologically confirmed PTC and clinically nodenegative lateral neck All patients underwent thyroidectomy with or without ipsilateral or bilateral central LND after intraoperative central LN biopsy Routine lateral neck LND was not performed Clinicopathologic and intraoperative findings and posttreatment recurrences were recorded Univariate and multivariate analyses with Coxproportional hazards model were used to identify factors associated with recurrenceDuring a followup of 50–96 months six 32 patients had recurrences in lateral cervical LNs at a median 28 months range 7–57 months after surgery Overall 2 and 5year RFS rates were 984 and 967 respectively Univariate analyses revealed that tumor size P = 0005 bilaterality P = 0033 T4 disease P 0001 and intraoperative diagnosis of central LNM P = 0001 were significantly predictive of recurrence Multivariate analyses showed that T4 disease P = 0049 and intraoperative diagnosis of central LNM P = 0027 were independently predictive of recurrence
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