title: Long-term outcomes of observation for clinically negative central compartment lymph nodes in papillary thyroid carcinoma.
abstract: The treatment strategy for clinically negative lymph nodes of papillary thyroid carcinoma is controversial. We report the long-term outcomes of a series of cases treated with thyroidectomy without prophylactic central neck dissection. We reviewed 1,397 cases with papillary thyroid carcinoma treated at our institution between 1991 and 2000. One hundred and seventy-two newly diagnosed cases underwent observation for cN0 central neck lymph nodes. Regional recurrence of the ipsilateral side including central compartment and the lateral neck which needs reoperation was considered as key point for analysis. With a mean follow-up of 96.4 months (34-204 months), the overall 10-year disease-specific and recurrence-free survival rates were 99 and 86 %, respectively. The recurrence and reoperation rates of the central compartment were 3 % (5/172) and 4 % (7/172), respectively. Univariate analysis showed that extrathyroidal extension was associated with regional recurrence (99 vs. 82 %; p = 0.002). Central compartment observation is safe in cN0 cases with papillary thyroid carcinoma, particularly in those without extrathyroidal extension.
authors.affiliation: Department of Head and Neck Surgical Oncology, Chinese Academy of Medical Science, Cancer Hospital, Beijing, China.
authors.forename: Jie
authors.initials: J
authors.lastname: Liu
authors.affiliation: Department of Head and Neck Surgical Oncology, Chinese Academy of Medical Science, Cancer Hospital, Beijing, China.
authors.forename: Zhengang
authors.initials: Z
authors.lastname: Xu
authors.affiliation: Department of Head and Neck Surgical Oncology, Chinese Academy of Medical Science, Cancer Hospital, Beijing, China.
authors.forename: Zhengjiang
authors.initials: Z
authors.lastname: Li
authors.affiliation: Department of Head and Neck Surgical Oncology, Chinese Academy of Medical Science, Cancer Hospital, Beijing, China.
authors.forename: Zongmin
authors.initials: Z
authors.lastname: Zhang
authors.affiliation: Department of Head and Neck Surgical Oncology, Chinese Academy of Medical Science, Cancer Hospital, Beijing, China.
authors.forename: Pingzhang
authors.initials: P
authors.lastname: Tang
authors.affiliation: Department of Head and Neck Surgical Oncology, Chinese Academy of Medical Science, Cancer Hospital, Beijing, China. liu_hns@163.com.|, No.17 Panjiayuan Nanli, Chaoyang District, Beijing, China. liu_hns@163.com.
authors.forename: Shaoyan
authors.initials: S
authors.lastname: Liu
mesh_terms: D002277:Carcinoma / Q000601:surgery*; D002291:Carcinoma, Papillary; D018572:Disease-Free Survival; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D009364:Neoplasm Recurrence, Local / Q000601:surgery; D012086:Reoperation; D000077273:Thyroid Cancer, Papillary; D013964:Thyroid Neoplasms / Q000601:surgery*; D013965:Thyroidectomy; D057832:Watchful Waiting
keywords: Cervical neoplasm; Follow-up studies; Lymph nodes dissection; Papillary carcinoma; Recurrence