Recurrence and Complications from the Surgical Procedure for Treating a Papillary Thyroid Carcinoma

ABSTRACT

PURPOSE: Papillary thyroid carcinoma is the most common endocrine malignancy. Despite the recent advances in diagnosis, controversy still remains concerning the surgical management. In order to select the appropriate surgical treatment, the outcome of different types of surgical procedures were reviewed. METHODS: 435 patients with papillary thyroid carcinoma who underwent surgery from January 1988 to December 1999 were retrospectively reviewed. The 12 years were divided into two periods; period 1 was from 1988 to 1993 (234 patients) and period 2 was from 1994 to 1999 (201 patients). The recurrence and complication rates according to the operation method, including a neck lymph node dissection, were analyzed. RESULTS: Twenty-six (10.7%) and 13 patients (6.5%) had a recurrence in period 1 and 2, respectively. Eighty-one (34.6%) and 51 patients (25.4%) had a postoperative complication including hypoparathyroidism and hoarseness in period 1 and 2, respectively. 271 patients (62.3%) had a lymph node metastasis, and the anterior neck was the most common site of metastasis (60.2%). CONCLUSION: A total thyroidectomy with a routine central node dissection reduces both the incidence and number of postoperative complications.