Abstract | OBJECTIVE: To explore the safety and efficacy of central compartment neck dissection (CCND) in the treatment of well-differentiated thyroid carcinoma (WDTC) recurrences in the central compartment of the neck. DESIGN: Retrospective medical chart review. SETTING: Tertiary-care academic hospital. PATIENTS: Eighty-two consecutively treated patients with recurrent WDTC, with a median follow-up of 28 months. MAIN OUTCOME MEASURES: Postoperative complications, disease control posttreatment, and normalization of serum thyroglobulin (Tg) level. RESULTS: Eighty-two patients underwent 86 central compartment procedures. Only CCND was performed in 36 patients (42%), while a lateral neck dissection was also required in the remainder. Postoperative hypoparathyroidism was temporary in 17 patients (20%) and permanent in 6 patients (7%). Postoperative intact serum parathyroid hormone level was greater than 15.0 pg/mL (to convert to nanograms per liter, multiply by 1.0) in 81% of patients, accurately predicting eucalcemia postoperatively. Unilateral recurrent laryngeal nerve injury was transient in 3 patients (2% of nerves at risk) and permanent in 3 patients (2%). Seventeen patients (21%) experienced subsequent recurrences after their CCND-2 patients (2%) had recurrence in the central neck, 8 (9%) in the lateral neck, 2 (2%) in the central and lateral neck, and 7 (8%) at distant sites. Twenty-seven patients underwent a CCND alone and were deemed appropriate for efficacy analysis. The Tg level was normalized in 15 patients (56%) in the group overall. Normalization occurred in 10 of the 20 patients (50%) who received sodium iodide I 131 ablation and in 5 of the 7 patients (71%) who did not. CONCLUSION: Central compartment neck dissection is a safe and efficacious procedure for the management of central neck recurrences in WDTC.
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Authors | Manish D Shah, Luke D Harris, Ramez G Nassif, Dae Kim, Spiro Eski, Jeremy L Freeman |
Journal | Archives of otolaryngology--head & neck surgery
(Arch Otolaryngol Head Neck Surg)
Vol. 138
Issue 1
Pg. 33-7
(Jan 2012)
ISSN: 1538-361X [Electronic] United States |
PMID | 22249626
(Publication Type: Journal Article, Research Support, Non-U.S. Gov't)
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Topics |
- Adult
- Aged
- Carcinoma
(pathology, surgery)
- Female
- Follow-Up Studies
- Humans
- Male
- Middle Aged
- Neck Dissection
(methods)
- Neoplasm Recurrence, Local
- Patient Safety
- Retrospective Studies
- Thyroid Neoplasms
(pathology, surgery)
- Treatment Outcome
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