title: Efficacy and safety of central compartment neck dissection for recurrent thyroid carcinoma.
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.
  
  
  METHODS
  Retrospective medical chart review.
  
  
  METHODS
  Tertiary-care academic hospital.
  
  
  METHODS
  Eighty-two consecutively treated patients with recurrent WDTC, with a median follow-up of 28 months.
  
  
  METHODS
  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.
  
  
  CONCLUSIONS
  Central compartment neck dissection is a safe and efficacious procedure for the management of central neck recurrences in WDTC.
authors.affiliation: Department of Otolaryngology-Head & Neck Surgery, Mount Sinai Hospital, Toronto, ON, Canada.
authors.forename: Manish D
authors.initials: MD
authors.lastname: Shah
authors.forename: Luke D
authors.initials: LD
authors.lastname: Harris
authors.forename: Ramez G
authors.initials: RG
authors.lastname: Nassif
authors.forename: Dae
authors.initials: D
authors.lastname: Kim
authors.forename: Spiro
authors.initials: S
authors.lastname: Eski
authors.forename: Jeremy L
authors.initials: JL
authors.lastname: Freeman
mesh_terms: D000328:Adult; D000368:Aged; D002277:Carcinoma / Q000473:pathology / Q000601:surgery*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D037981:Neck Dissection / Q000379:methods*; D009364:Neoplasm Recurrence, Local; D061214:Patient Safety; D012189:Retrospective Studies; D013964:Thyroid Neoplasms / Q000473:pathology / Q000601:surgery*; D016896:Treatment Outcome