title: Role of prophylactic central neck dissection in cN0-papillary thyroid carcinoma: results from a high-prevalence area.
abstract: BACKGROUND
  Prophylactic, compartment-oriented central neck dissection (CND) for cN0 papillary thyroid carcinoma (PTC) is not widely practiced. We examined our results with this surgical approach.
  
  
  METHODS
  A cohort of 158 patients operated on for the classical variant of PTC at a follow-up of 1-22 years (mean: 6.6) were enrolled. The patients with a preoperative diagnosis of cN0 PTC (group A, 59 patients) underwent total thyroidectomy (TT) + CND. In the patients with incidental postoperative diagnosis of malignancy (group B, 99 patients) a TT alone was performed.
  
  
  RESULTS
  Ninety-six T1, 36 T2, 26 T3/T4 PTC patients were enrolled. The overall biochemical/scintigraphic recurrence rate (15 patients, 9.49%), was significantly higher in group B. Disease-free survival and need for postoperative radioiodine ablative treatment were more favorable in group A (P<0.05; P<0.001, respectively). The median radioiodine ablative treatment in the T2 cluster alone was lower in group A (P<0.001). The morbidity rate was similar in both groups.
  
  
  CONCLUSIONS
  Considering the acceptable morbidity, prophylactic CND seems to be advantageous in terms of recurrence rate and need for radioiodine treatment in this variant of PTC, at least in T2 or more advanced stages. The indolent behavior of PTC does not allow for reliable prognostic evaluations.
authors.affiliation: Unit of General and Emergency Surgery, Department of General, Emergency and Transplant Surgery, P. Giaccone Policlinico, Palermo, Italy - gregorio.scerrino@tiscali.it.
authors.forename: Gregorio
authors.initials: G
authors.lastname: Scerrino
authors.forename: Andrea
authors.initials: A
authors.lastname: Attard
authors.forename: Giuseppina I
authors.initials: GI
authors.lastname: Melfa
authors.forename: Cristina
authors.initials: C
authors.lastname: Raspanti
authors.forename: Silvia
authors.initials: S
authors.lastname: DI Giovanni
authors.forename: Marco
authors.initials: M
authors.lastname: Attard
authors.forename: Angela
authors.initials: A
authors.lastname: Inviati
authors.forename: Sergio
authors.initials: S
authors.lastname: Mazzola
authors.forename: Giuseppe
authors.initials: G
authors.lastname: Modica
authors.forename: Gaspare
authors.initials: G
authors.lastname: Gulotta
authors.forename: Sebastiano
authors.initials: S
authors.lastname: Bonventre
mesh_terms: D000328:Adult; D002291:Carcinoma, Papillary / Q000175:diagnosis / Q000453:epidemiology / Q000532:radiotherapy / Q000601:surgery*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D015994:Incidence; D007558:Italy / Q000453:epidemiology; D008297:Male; D008875:Middle Aged; D037981:Neck Dissection / Q000379:methods; D009364:Neoplasm Recurrence, Local / Q000175:diagnosis / Q000453:epidemiology / Q000532:radiotherapy / Q000601:surgery*; D009367:Neoplasm Staging; D015995:Prevalence; D012086:Reoperation; D012189:Retrospective Studies; D015996:Survival Rate; D013964:Thyroid Neoplasms / Q000175:diagnosis / Q000453:epidemiology / Q000532:radiotherapy / Q000601:surgery*; D013965:Thyroidectomy / Q000379:methods; D016896:Treatment Outcome