Salvage central neck dissection for papillary thyroid cancer / 中华耳鼻咽喉头颈外科杂志

ABSTRACT

<p><b>OBJECTIVE</b>To evaluate the salvage central neck dissection (CND) for papillary thyroid cancer in the patients with suspicious residual positive lymph nodes in the central compartment.</p><p><b>METHODS</b>A total of 85 cases undergoing salvage CND between January 2006 to January 2009 was reviewed.</p><p><b>RESULTS</b>Fifty-nine (69.4%) of the 85 patients showed residual positive lymph nodes in the central compartments. The number of dissected lymph nodes for each dissection ranged 2 - 13 nodes, with an average of 5.7 nodes. A total of 159 positive lymph nodes were found in the 59 cases, with an average of 2.7 positive nodes in each case. Four of 6 patients who underwent initial CND in other hospitals were found with residual positive nodes in the central apartments. The incidence of postoperative complications for the salvage CND was 10.6% (9/85), of them 5 cases with hoarseness, 2 cases with transient hypoparathyroidism, 1 case with postoperative bleeding, and 1 case with subplatysmal effusion. The median of follow-up after salvage CND was 44 months (3 - 5 years), showing contralateral central recurrence in 1 case, lateral neck recurrence in 4 cases, lung metastasis in 1 case, and no death case.</p><p><b>CONCLUSIONS</b>Salvage CND should be done for those patients without undergoing initial CND but with positive nodes found after thyroidectomy or the high risks (T3, T4, extra thyroid extension, residual in primary site, and vascular or lymphatic vessel invasion); and also for those patients with initial CND but insufficient extent.</p>