title: Impact of prophylactic central compartment neck dissection on locoregional recurrence of differentiated thyroid cancer in clinically node-negative patients: a retrospective study of a large clinical series.
abstract: BACKGROUND
  In clinically node-negative patients with differentiated thyroid cancer (DTC), indications for routine central lymph node dissection (RCLD) are the subject of intensive research, and surgeons are divided between the pros and cons of this surgery. To better define the role of neck dissection in the treatment of DTC, we analyzed retrospectively the results in three centers in Italy.
  
  
  METHODS
  The clinical records of 752 clinically node-negative patients with DTC who underwent operative treatment between January 1998 and December 2005 in three endocrine surgery referral units were evaluated retrospectively. The complications and medium- and long-term outcomes of total thyroidectomy (TT) alone (performed in 390 patients: group A) and TT combined with bilateral RCLD (362 patients: group B) were analyzed and compared.
  
  
  RESULTS
  The incidence of permanent hypoparathyroidism and permanent unilateral vocal folds was 1% and 0.8% in group A and 3.6% and 1.7% in the group B, respectively. Bilateral temporary recurrent nerve palsy was observed in one of the 362 patients in group B. After a follow-up of 9.5 ± 3.5 years (mean ± SD), the locoregional recurrence rate with positive cervical lymph nodes was not substantially significantly different between the two groups.
  
  
  CONCLUSIONS
  In our series, TT combined with bilateral RCLD was associated with a greater rate of transient and permanent complications. Similar incidences of locoregional recurrence were reported in the two groups of patients. Considering the recent trend toward routine central lymphadenectomy, further studies are needed to evaluate the benefits of these different approaches.
authors.affiliation: Department of Anesthesiologic, Surgical and Emergency Sciences, VII Division of General and Endocrine Surgery, Second University of Naples, Naples, Italy. Electronic address: giovanni.conzo@unina2.it.
authors.forename: Giovanni
authors.initials: G
authors.lastname: Conzo
authors.affiliation: Department of Surgical Sciences, University of Cagliari, Cagliari, Italy.
authors.forename: Pietro Giorgio
authors.initials: PG
authors.lastname: Calò
authors.affiliation: Department of Cardio-Thoracic and Respiratory Sciences, Endocrinology Unit, Second University of Naples, Naples, Italy.
authors.forename: Antonio A
authors.initials: AA
authors.lastname: Sinisi
authors.affiliation: Department of Cardio-Thoracic and Respiratory Sciences, Endocrinology Unit, Second University of Naples, Naples, Italy.
authors.forename: Annamaria
authors.initials: A
authors.lastname: De Bellis
authors.affiliation: Department of Cardio-Thoracic and Respiratory Sciences, Endocrinology Unit, Second University of Naples, Naples, Italy.
authors.forename: Daniela
authors.initials: D
authors.lastname: Pasquali
authors.affiliation: Department of Cardio-Thoracic and Respiratory Sciences, Endocrinology Unit, Second University of Naples, Naples, Italy.
authors.forename: Sergio
authors.initials: S
authors.lastname: Iorio
authors.affiliation: Department of Anesthesiologic, Surgical and Emergency Sciences, VII Division of General and Endocrine Surgery, Second University of Naples, Naples, Italy.
authors.forename: Ernesto
authors.initials: E
authors.lastname: Tartaglia
authors.affiliation: Department of Anesthesiologic, Surgical and Emergency Sciences, VII Division of General and Endocrine Surgery, Second University of Naples, Naples, Italy.
authors.forename: Claudio
authors.initials: C
authors.lastname: Mauriello
authors.affiliation: Department of Anesthesiologic, Surgical and Emergency Sciences, VII Division of General and Endocrine Surgery, Second University of Naples, Naples, Italy.
authors.forename: Claudio
authors.initials: C
authors.lastname: Gambardella
authors.affiliation: Department of Anesthesiologic, Surgical and Emergency Sciences, VII Division of General and Endocrine Surgery, Second University of Naples, Naples, Italy.
authors.forename: Fabio
authors.initials: F
authors.lastname: Cavallo
authors.affiliation: Department of Surgical Sciences, University of Cagliari, Cagliari, Italy.
authors.forename: Fabio
authors.initials: F
authors.lastname: Medas
authors.affiliation: Endocrine Surgery Unit, University of Perugia, Perugia, Italy.
authors.forename: Andrea
authors.initials: A
authors.lastname: Polistena
authors.affiliation: Department of Anesthesiologic, Surgical and Emergency Sciences, VII Division of General and Endocrine Surgery, Second University of Naples, Naples, Italy.
authors.forename: Luigi
authors.initials: L
authors.lastname: Santini
authors.affiliation: Endocrine Surgery Unit, University of Perugia, Perugia, Italy.
authors.forename: Nicola
authors.initials: N
authors.lastname: Avenia
mesh_terms: D000328:Adult; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D015994:Incidence; D008207:Lymphatic Metastasis; D008297:Male; D008875:Middle Aged; D037981:Neck Dissection / Q000379:methods*; D009364:Neoplasm Recurrence, Local / Q000517:prevention & control*; D011183:Postoperative Complications / Q000453:epidemiology; D012189:Retrospective Studies; D013964:Thyroid Neoplasms / Q000473:pathology / Q000601:surgery*; D013965:Thyroidectomy; D016896:Treatment Outcome