title: The incidence of central neck micrometastatic disease in patients with papillary thyroid cancer staged preoperatively and intraoperatively as N0.
abstract: BACKGROUND
  In papillary thyroid cancer, the incidence of regional lymph node metastasis in the central compartment has been reported to be between 21% and 60%. This study sought to establish the rate of micrometastatic disease in the central neck in patients staged as N0 by preoperative and intraoperative assessment.
  
  
  METHODS
  We studied 72 consecutive patients with diagnoses of papillary thyroid cancer without preoperative or intraoperative evidence of central neck metastases. They underwent total thyroidectomies and were given elective central compartment neck dissection (CCND) ispsilateral to the lobe harboring the tumor or bilaterally in cases of primary tumor located in the isthmus.
  
  
  RESULTS
  Of the patients, 30 underwent right CCND, 30 underwent left CCND, and in 12 cases the dissection was bilateral. The incidence of lymph node micrometastasis was 25%. Male gender and histologic type showed association with lymph node micrometasis. Among these cases, 7% had temporary vocal cord palsy, and 8% had temporary hypoparathyroidism. No cases of definitive vocal cord palsy or definitive hypocalcemia were observed. After the procedure 8 patients were up-staged according to the American Joint Committee on Cancer staging system.
  
  
  CONCLUSIONS
  Despite being a safe procedure, this relatively low rate of micrometastatic disease emphasizes the need for a careful weighing of the risks and benefits of elective CCND.
authors.affiliation: Department of Oncologic Surgery/Head and Neck Surgery CEPON, Florianopolis, SC, Brazil. gteixei1@gmail.com
authors.forename: Gilberto
authors.initials: G
authors.lastname: Teixeira
authors.forename: Thiago
authors.initials: T
authors.lastname: Teixeira
authors.forename: Fernando
authors.initials: F
authors.lastname: Gubert
authors.forename: Horácio
authors.initials: H
authors.lastname: Chikota
authors.forename: Ralph
authors.initials: R
authors.lastname: Tufano
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D002277:Carcinoma; D002291:Carcinoma, Papillary; D005260:Female; D006801:Humans; D015994:Incidence; D007432:Intraoperative Period; D008207:Lymphatic Metastasis; D008297:Male; D008875:Middle Aged; D009333:Neck; D037981:Neck Dissection; D061206:Neoplasm Micrometastasis; D009367:Neoplasm Staging / Q000379:methods; D057234:Preoperative Period; D012737:Sex Factors; D000077273:Thyroid Cancer, Papillary; D013964:Thyroid Neoplasms / Q000473:pathology* / Q000601:surgery; D013965:Thyroidectomy; D055815:Young Adult