Feasibility of super-selective neck dissection for indeterminate lateral neck nodes in papillary thyroid carcinoma.

Background: Therapeutic lateral compartment neck dissection is recommended for cases of papillary thyroid carcinoma with biopsy-proven lymph node metastasis. The purpose of this study was to evaluate the efficacy and safety of super-selective neck dissection for patients with clinically suspicious lymph node metastasis not confirmed by biopsy.

Methods: Among 620 patients treated for papillary thyroid carcinoma between 2008 and 2010, 34 had suspicious lymph node enlargement in the lateral neck and underwent total thyroidectomy with super-selective neck dissection.

Results: Metastatic disease was confirmed in 38.2% patients (13 of 34) with indeterminate lymph nodes identified by preoperative CT and/or ultrasonography who underwent super-selective neck dissection. Most harvested lymph nodes were located at level IV. There was no recurrence during a mean follow-up period of 31.6 months.

Conclusion: Patients with clinically suspicious lateral neck nodes that are not confirmed by biopsy may be good candidates for super-selective neck dissection, which had minimal morbidity and did not compromise oncologic outcomes.