Prophylactic central lymph node dissection in node negative papillary thyroid cancer : A retrospective study in peripheral cancer centre
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Keywords
lymph , node, papillary, cancer
Abstract
Papillary thyroid cancers are most common thyroid cancers . They are associated with good prognosis . Central lymph node metastasis is associated with poor prognosis . We did a retrospective analysis of patients treated with surgery for papillary thyroid cancers . twenty one patients were included in study . We sought to find any relation between age , gender size of tumour and other histological features with central lymph node metastasis in patients with papillary thyroid cancers .
Introduction : Papillary thyroid cancer is most common thyroid cancer and carries best overall prognosis . The incidence of PTC has been increasing , partly due to increased diagnosis , imaging ,cytology .(1,2)
During surgery, central lymph node metastases were observed in 20% to 90% of PTMC patients in different studies, despite negative preoperative imaging evaluation .(3,4,5) . Overall survival of papillary thyroid cancers is around 95 percent . Lymph node metastases are also known to be an independent risk factor for local recurrence .(6) . Central neck lymph node dissection (CLND) includes level VI, the anatomic area bounded by the hyoid bone superiorly, the sternal notch inferiorly, and the medial borders of the carotid sheaths laterally. The structures in this compartment are the esophagus, recurrent laryngeal nerves, trachea, parathyroid glands, thymus, and the thyroid gland. The included lymph nodes are the pre-tracheal, para-tracheal and pre-laryngeal (also called Delphian). Prophylactic central neck lymph node dissection remains contested .
The present study aims to evaluate the incidence of CLNM at a single institution over 3 years, and to identify possible risk factors associated with the presence of CLNM.
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Amarendra Dharwar
Assisstant professor , Department of surgical oncology , VTSM peripheral cancer centre , Kalaburagi
Gururaj Deshpande
Assisstant professor , Department of surgical oncology , VTSM peripheral cancer centre , Kalaburagi
Ramya Krishna
Senior resident , department of surgical oncology , kidwai memorial institute of oncology , bangalore