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Prophylactic neck dissection for low‐risk differentiated thyroid cancers: Risk‐benefit analysis
Author(s) -
Dubernard Xavier,
Dabakuyo Sandrine,
Ouedraogo Samiratou,
Amroun Koceila,
Kere David,
Nasser Talal,
Deguelte Sophie,
Pochart JeanMarie,
Merol JeanClaude,
Makeieff Marc,
Chays André,
Schvartz Claire
Publication year - 2016
Publication title -
head and neck
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.012
H-Index - 127
eISSN - 1097-0347
pISSN - 1043-3074
DOI - 10.1002/hed.24402
Subject(s) - medicine , neck dissection , hypoparathyroidism , dissection (medical) , surgery , thyroidectomy , thyroid , thyroid cancer , retrospective cohort study , head and neck cancer , head and neck , cancer , radiation therapy
Background The benefit of neck dissection is the subject of debate in differentiated thyroid cancer (DTC). We analyze the risk‐benefit of neck dissection for low‐risk DTC without detectable lymph nodes. Methods We conducted a retrospective study from 1983 to 2003; which included 295 patients without detectable lymph nodes who were treated by thyroidectomy with (C+) or without (C‐) neck dissection. All patients had iodine131 therapy. We compared the frequency of remission, disease progression, and permanent complications between groups. Results Two hundred twelve patients comprised the C+ group, and 83 patients the C‐ group. Respectively for C+ versus C‐, remission rates were 92% versus 89.2% ( p = .40), and progressive disease observed was 3.3% versus 7.2% ( p = .10). Permanent hypoparathyroidism occurred in 15.1% in C+ versus 3.6% in C‐ ( p = .006). Conclusion The risk‐benefit analysis of neck dissection in patients with low‐risk DTC shows no benefit in terms of complete remission or occurrence of progression. However, risk of complications seems to be higher in patients with neck dissection. © 2016 Wiley Periodicals, Inc. Head Neck 38: 1091–1096, 2016