Is Central Lymph Node Dissection Mandatory in 2 cm or Less Sized Papillary Thyroid Cancer?

ABSTRACT

PURPOSE: There have been controversies on the scope of central lymph node dissection (CND) in papillary thyroid cancer (PTC). We performed this study to determine the role of CND for patients having PTC measuring 2 cm or less. METHODS: 530 cases of PTC less than 2 cm had undergone lobectomy plus isthmectomy (LI) with CND or without CND. Clinicopathologic records and clinical outcome were evaluated, retrospectively. RESULTS: Comparing recurrence rates in LI with CND group (4/174, 2.30%) and LI without CND group (16/356, 4.49%), there was no significant statistical difference in recurrence (P=0.331). We compared 20 patients with recurrences and 510 patients of no recurrence. The size of tumor seemed to influence recurrence (P<0.001) and the size of tumor developing recurrence was larger than the other (1.11 cm vs. 0.75 cm). When considering division into PTC and papillary thyroid microcarcinoma (PTMC), PTMC showed less recurrence significantly (P=0.006). No other variables such as age, sex, tumor location, extrathyroidal extension seemed to be related to the recurrence. CONCLUSION: We could not find any relevant role of CND to prevent recurrence either locally or regionally in cases of no lymph node metastasis after CND for patients having PTC measuring 2 cm or less. Moreover, prophylactic CND is not mandatory for all cases of PTC less than 2 cm.