title: The Effect of Thyroiditis on the Yield of Central Compartment Lymph Nodes in Patients with Papillary Thyroid Cancer.
abstract: BACKGROUND
  In patients who have undergone thyroidectomy and central compartment neck dissection (CCND) for papillary thyroid cancer (PTC), visualization of enlarged lymph nodes may lead to more extensive CCND. This study sought to determine the effect of patient age and the presence of thyroiditis on the number of malignant and total lymph nodes resected in patients who underwent CCND for PTC.
  
  
  METHODS
  This retrospective review examined a prospective database of patients who underwent total thyroidectomy and CCND for PTC between April 2009 and June 2013 and had thyroiditis on the final pathology. The patients were categorized into age groups by decade (18-29, 30-39, 40-49, 50-59, and ≥60 years) and compared with a control group of patients matched by age, gender, and tumor size.
  
  
  RESULTS
  Of 74 patients with thyroiditis, 64 (87 %) were women. The median age of the patients was 47.5 years (range 18.2-72.0 years). The patients with thyroiditis had more lymph nodes resected than those without thyroiditis (median 11 vs 7; p < 0.01). However, these patients had fewer malignant lymph nodes (median 0 vs 1.5; p = 0.06), resulting in a lower lymph node ratio (0 vs 0.18; p = 0.02) for the entire cohort, but particularly for the youngest (18-29 years) and oldest (≥60 years) age groups.
  
  
  CONCLUSIONS
  Patients with thyroiditis and PTC who underwent CCND had more lymph nodes resected but a had lower proportion of metastatic lymph nodes than those without thyroiditis. Given the relatively low yield of malignant cervical lymphadenopathy, a more judicious approach to CCND might be considered, particularly for the youngest and oldest patients with PTC and thyroiditis.
authors: Virginia Hospital Center, Arlington, VA, USA.
authors: Victoria
authors: V
authors: Lai
authors: Division of Surgical Oncology, Department of Surgery, Medical College of Wisconsin, Milwaukee, WI, USA.
authors: Tina W F
authors: TW
authors: Yen
authors: Endocrine Center and Clinics, Medical College of Wisconsin, Milwaukee, WI, USA.
authors: Brian T
authors: BT
authors: Rose
authors: Division of Clinical Endocrinology, Metabolism, and Nutrition, Department of Medicine, Medical College of Wisconsin, Milwaukee, WI, USA.
authors: Gilbert G
authors: GG
authors: Fareau
authors: Division of Surgical Oncology, Department of Surgery, Medical College of Wisconsin, Milwaukee, WI, USA.
authors: Sarah M
authors: SM
authors: Misustin
authors: Division of Surgical Oncology, Department of Surgery, Medical College of Wisconsin, Milwaukee, WI, USA.
authors: Douglas B
authors: DB
authors: Evans
authors: Division of Surgical Oncology, Department of Surgery, Medical College of Wisconsin, Milwaukee, WI, USA. tswang@mcw.edu.
authors: Tracy S
authors: TS
authors: Wang
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D002291:Carcinoma, Papillary / Q000150:complications / Q000556:secondary* / Q000601:surgery; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008197:Lymph Node Excision; D008198:Lymph Nodes / Q000473:pathology*; D008207:Lymphatic Metastasis; D008297:Male; D008875:Middle Aged; D009367:Neoplasm Staging; D011379:Prognosis; D011446:Prospective Studies; D012189:Retrospective Studies; D013964:Thyroid Neoplasms / Q000150:complications / Q000473:pathology* / Q000601:surgery; D013965:Thyroidectomy; D013966:Thyroiditis / Q000150:complications*; D055815:Young Adult