title: Significance of prophylactic modified radical neck dissection for patients with low-risk papillary thyroid carcinoma measuring 1.1-3.0 cm: first report of a trial at Kuma Hospital.
abstract: OBJECTIVE
  Papillary thyroid carcinoma (PTC) frequently metastasizes to and recurs in regional lymph nodes. Of the two compartments, the central compartment can be dissected through the same wound as the thyroidectomy, and the central node dissection (CND) is routinely performed in most Japanese surgical departments. However, the indications for prophylactic lateral compartment dissection (modified radical neck dissection [MND]) for low-risk PTC remain unclear. In this study, we investigated the indications for prophylactic MND for PTC patients with tumor measuring 1.1-3.0 cm without significant extrathyroid extension or distant metastasis.
  
  
  METHODS
  We investigated the lymph node disease-free survival (LN-DFS) rates of 829 patients who underwent CND and of 414 patients who underwent MND and CND between 2005 and 2007 at Kuma Hospital.
  
  
  RESULTS
  The LN-DFS of these two groups was not significantly different. In the subset of patients with CND only, clinical central node metastasis (N1a) significantly predicted a worse LN-DFS. All N1a patients recognized as showing recurrence developed such recurrence in the lateral compartment. Other conventional prognostic factors, such as sex and age, were not related to LN-DFS.
  
  
  CONCLUSIONS
  Taken together, N1a patients with low-risk PTC measuring 1.1-3.0 cm can be considered as candidates for prophylactic MND.
authors.affiliation: Department of Surgery, Kuma Hospital, 8-2-35 Shimoyamate-dori, Chuo-ku, Kobe, 650-0011, Japan.
authors.forename: Yasuhiro
authors.initials: Y
authors.lastname: Ito
authors.forename: Yukiko
authors.initials: Y
authors.lastname: Tsushima
authors.forename: Hiroo
authors.initials: H
authors.lastname: Masuoka
authors.forename: Tomonori
authors.initials: T
authors.lastname: Yabuta
authors.forename: Mitsuhiro
authors.initials: M
authors.lastname: Fukushima
authors.forename: Hiroyuki
authors.initials: H
authors.lastname: Inoue
authors.forename: Chisato
authors.initials: C
authors.lastname: Tomoda
authors.forename: Minoru
authors.initials: M
authors.lastname: Kihara
authors.forename: Takuya
authors.initials: T
authors.lastname: Higashiyama
authors.forename: Yuuki
authors.initials: Y
authors.lastname: Takamura
authors.forename: Kaoru
authors.initials: K
authors.lastname: Kobayashi
authors.forename: Akihiro
authors.initials: A
authors.lastname: Miya
authors.forename: Akira
authors.initials: A
authors.lastname: Miyauchi
mesh_terms: D000328:Adult; D000368:Aged; D002277:Carcinoma; D002291:Carcinoma, Papillary; D015331:Cohort Studies; D018572:Disease-Free Survival; D005260:Female; D006801:Humans; D007564:Japan; D053208:Kaplan-Meier Estimate; D008197:Lymph Node Excision / Q000379:methods* / Q000401:mortality; D008198:Lymph Nodes / Q000473:pathology*; D008297:Male; D008875:Middle Aged; D037981:Neck Dissection / Q000379:methods* / Q000401:mortality; D009361:Neoplasm Invasiveness / Q000473:pathology; D009364:Neoplasm Recurrence, Local / Q000401:mortality / Q000473:pathology / Q000517:prevention & control; D009367:Neoplasm Staging; D011322:Primary Prevention / Q000379:methods*; D011379:Prognosis; D012189:Retrospective Studies; D018570:Risk Assessment; D018709:Statistics, Nonparametric; D016019:Survival Analysis; D000077273:Thyroid Cancer, Papillary; D013964:Thyroid Neoplasms / Q000401:mortality / Q000473:pathology* / Q000601:surgery; D016896:Treatment Outcome