Risk of Contralateral Central Compartment Recurrence Following Unilateral Therapeutic Neck Dissection for Papillary Thyroid Carcinoma

IF 1.9 3区医学 Q3 ONCOLOGY

Journal of Surgical Oncology Pub Date : 2025-08-06 DOI:10.1002/jso.70063

Keren Kaminer, Tal Rozenblat, Itay Shavit, Inbar Finkel, Liat Sasson, Ilan Shimon, Dania Hirsch, Gideon Bachar, Eyal Robenshtok

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Abstract

Background and Objectives

The utility of bilateral central compartment neck dissection (CCND) in patients with papillary thyroid carcinoma (PTC) and unilateral clinically node-positive disease remains debatable. Previous studies evaluated contralateral occult lymph-node metastases, which do not necessarily correlate with clinical recurrences. The objective of our study was to evaluate whether unilateral CCND is sufficient, specifically evaluating recurrence in the contralateral central neck.

Methods

Patients with PTC treated with total thyroidectomy and therapeutic unilateral CCND with at least 2 years of follow-up were included.

Results

A total of 118 patients had unilateral therapeutic CCND, 58% with lateral neck dissection, 63% female, mean age of 48.1 ± 16.3 years. Mean follow-up was 6.2 ± 3.9 years, tumor size 17.6 ± 12 mm, 39% had minimal extrathyroidal extension (ETE) and 4% had gross ETE. A mean of 2.6 ± 2.6 LN were involved in the central compartment (size 9.4 ± 6.5 mm) and 4.4 ± 4 involved in the lateral neck (size 24.9 ± 14.3 mm). Recurrence on the ipsilateral side was detected in 6 patients (5%), while contralateral central compartment recurrence (the primary outcome) was detected in only 1 patient (1%).

Conclusions

In patients with PTC and unilateral clinically node-positive central compartment disease, unilateral therapeutic CCND is sufficient, with only 1% risk of recurrence in the contralateral central compartment.

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甲状腺乳头状癌单侧治疗性颈部清扫术后对侧中央室复发的风险。

背景和目的：双侧中央室颈清扫术（CCND）在甲状腺乳头状癌（PTC）和单侧临床淋巴结阳性疾病患者中的应用仍有争议。先前的研究评估了对侧隐匿淋巴结转移，这与临床复发并不一定相关。我们研究的目的是评估单侧CCND是否足够，特别是评估对侧中央颈部的复发。方法：对经甲状腺全切除术和治疗性单侧CCND治疗的PTC患者进行至少2年的随访。结果：单侧治疗性CCND 118例，其中58%合并侧颈清扫，63%为女性，平均年龄48.1±16.3岁。平均随访时间为6.2±3.9年，肿瘤大小为17.6±12 mm，轻度甲状腺外扩张（te） 39%，明显te 4%。平均有2.6±2.6个LN累及中央腔室（大小9.4±6.5 mm）， 4.4±4个LN累及侧颈（大小24.9±14.3 mm）。6例患者（5%）发现同侧复发，而对侧中央室复发（主要结局）仅1例患者（1%）发现。结论：对于PTC和单侧临床淋巴结阳性中央室疾病的患者，单侧治疗性CCND是足够的，对侧中央室复发的风险仅为1%。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Journal of Surgical Oncology 医学-外科

CiteScore

4.70

自引率

4.00%

发文量

367

审稿时长

2 months

期刊介绍： The Journal of Surgical Oncology offers peer-reviewed, original papers in the field of surgical oncology and broadly related surgical sciences, including reports on experimental and laboratory studies. As an international journal, the editors encourage participation from leading surgeons around the world. The JSO is the representative journal for the World Federation of Surgical Oncology Societies. Publishing 16 issues in 2 volumes each year, the journal accepts Research Articles, in-depth Reviews of timely interest, Letters to the Editor, and invited Editorials. Guest Editors from the JSO Editorial Board oversee multiple special Seminars issues each year. These Seminars include multifaceted Reviews on a particular topic or current issue in surgical oncology, which are invited from experts in the field.