Premium
Factors affecting the adequacy of lymph node yield in prophylactic unilateral central neck dissection for papillary thyroid carcinoma
Author(s) -
Lang Brian HungHin,
Yih Patricia ChunLing,
Shek Tony W.H.,
Wan Koon Yat,
Wong Kai Pun,
Lo ChungYau
Publication year - 2012
Publication title -
journal of surgical oncology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.201
H-Index - 111
eISSN - 1096-9098
pISSN - 0022-4790
DOI - 10.1002/jso.23201
Subject(s) - neck dissection , medicine , lymph node , thyroid carcinoma , thyroidectomy , dissection (medical) , univariate analysis , carcinoma , thyroglobulin , surgery , multivariate analysis , thyroid , pathology
Background Determinants for adequate lymph node yield (LNY) in prophylactic central neck dissection (pCND) for papillary thyroid carcinoma (PTC) remain unclear. We aimed to determine factors affecting LNY in pCND. Methods Of 230 patients, 109 (47.4%) had total thyroidectomy and unilateral pCND. A specimen of ≥6 central lymph nodes (CLNs) was considered adequate. Factors such as patient clinicopathologic features, specimen dimensions, and pathologists' experience were compared between those with LNY < 6 (n = 52) and LNY ≥ 6 (n = 57). A multivariate analysis was conducted to identify independent factors for LNY ≥ 6. Results Age, sex, presentation, body mass index, tumor characteristics, TNM stages, MACIS score, and pathologist's experience were not significant determinants for LNY ≥ 6. In the univariate analysis, the length ( P = 0.021), width ( P = 0.047), thickness ( P = 0.024), and pN1a ( P = 0.042) were significant determinants but in the multivariate analysis, the length (OR = 1.486 (95% CI: 1.053–2.097), P = 0.024) was the only independent factor for LNY ≥ 6. Postoperative vocal cord palsy, hypoparathyroidism, stimulated thyroglobulin and recurrences were similar between LNY <6 and ≥6. Conclusions Length (or the longest measured dimension) of the fresh CLN specimen was the only factor assuring LNY ≥ 6. Surgical complications and short‐term outcomes appeared similar between LNY <6 or ≥6. J. Surg. Oncol. 2012; 106: 966–971. © 2012 Wiley Periodicals, Inc.