title: Central neck dissection in papillary thyroid carcinoma: results of a retrospective study.
abstract: OBJECTIVE
  The aim of this retrospective study was to appraise the impact of central neck dissection (CND) when treating papillary thyroid carcinoma (PTC) and identifying predictors of tumour recurrence by analysing the results and complications related to this surgical procedure.
  
  
  METHODS
  The study examined the histories of 347 patients with PTC, divided into two groups: group A including 284 patients who underwent total thyroidectomy (TT) only; group B including 63 patients who underwent TT and CND and possible lateral neck dissection (LND).
  
  
  RESULTS
  The patients in the B group were younger than those in the A group (an average of 44.5 vs. 48.6; p = 0.03) and their tumours were larger (1.91 cm vs 1.27 cm, p = 0.001). Multifocality, extra-capsular extensions of the neoplastic mass and high cell histological variant were more prevalent in the B group. The incidence of permanent hyperparathyroidism was higher in group B than in group A (25.4% vs 9.5%, p = 0.0006). Recurrence of disease and the numbers requiring reoperation were also higher in group B: (24.1% in group B vs 6.6 in group A, p < 0.0001). Patients classified as clinically N0 at their first operation and who were most probably clinically N1, totalled 6.6%.
  
  
  CONCLUSIONS
  Our data show that only extra-capsular extension may be considered a predictor of recurrence. The findings of our study support the idea of carrying out "therapeutic" CND only in cases of preoperative or macroscopic intraoperative clinical evidence of lymph-node involvement.
authors.affiliation: Department of Surgical Sciences, "Sapienza" University of Rome, Rome, Italy. Electronic address: francesco.tartaglia@uniroma1.it.
authors.forename: F
authors.initials: F
authors.lastname: Tartaglia
authors.affiliation: Department of Surgical Sciences, "Sapienza" University of Rome, Rome, Italy.
authors.forename: S
authors.initials: S
authors.lastname: Blasi
authors.affiliation: Istituto Superiore di Sanità, Rome, Italy.
authors.forename: A
authors.initials: A
authors.lastname: Giuliani
authors.affiliation: Department of Surgical Sciences, "Sapienza" University of Rome, Rome, Italy.
authors.forename: M
authors.initials: M
authors.lastname: Sgueglia
authors.affiliation: Department of Surgical Sciences, "Sapienza" University of Rome, Rome, Italy.
authors.forename: L
authors.initials: L
authors.lastname: Tromba
authors.affiliation: Department of Surgical Sciences, "Sapienza" University of Rome, Rome, Italy.
authors.forename: S
authors.initials: S
authors.lastname: Carbotta
authors.affiliation: Department of Surgical Sciences, "Sapienza" University of Rome, Rome, Italy.
authors.forename: G
authors.initials: G
authors.lastname: Carbotta
authors.affiliation: Department of Surgical Sciences, "Sapienza" University of Rome, Rome, Italy.
authors.forename: G
authors.initials: G
authors.lastname: Tortorelli
mesh_terms: D000328:Adult; D000368:Aged; D002277:Carcinoma / Q000473:pathology / Q000601:surgery*; D002291:Carcinoma, Papillary; D005260:Female; D006801:Humans; D015994:Incidence; D008207:Lymphatic Metastasis; D008297:Male; D008875:Middle Aged; D037981:Neck Dissection / Q000379:methods; D009364:Neoplasm Recurrence, Local / Q000453:epidemiology; D012086:Reoperation / Q000706:statistics & numerical data; D012189:Retrospective Studies; D000077273:Thyroid Cancer, Papillary; D013964:Thyroid Neoplasms / Q000473:pathology / Q000601:surgery*; D013965:Thyroidectomy / Q000379:methods; D016896:Treatment Outcome
keywords: Central neck dissection; Papillary thyroid carcinoma; Total thyroidectomy