title: Prophylactic central lymph node dissection in cN0 patients with papillary thyroid carcinoma: A retrospective study in China.
abstract: OBJECTIVE
  The objective of the study was to assess the patterns of central cervical lymph node metastasis (CLNM) and evaluate the prophylactic central lymph node dissection (CLND) in papillary thyroid carcinoma (PTC) patients without clinical positive lymph nodes.
  
  
  METHODS
  We retrospectively reviewed 1555 patients with PTC between 2003 and 2008. Lymph node metastatic risk factors and the pattern of lymph node metastasis in PTC were studied using multivariate analysis.
  
  
  RESULTS
  Male patients, aged ≤ 45 years, the presence of extrathyroidal extension, and a primary tumor size > 10 mm were identified as risk factors for CLNM with odds ratios of 2.089, 2.417, 1.534, and 3.079, respectively. Among 1555 patients, 97 cases (6.24%) had transient hypoparathyroidism, and only two patients (0.13%) had permanent hypoparathyroidism. Recurrent laryngeal nerve injury after thyroidectomy occurred in 14 patients (0.9%). In this group, nine cases were transient injury and the remaining five were permanent. During the period of follow-up, ranging from 5 years to 10 years, 18 patients (1.16%) were found with locoregional recurrence.
  
  
  CONCLUSIONS
  Taken together, in terms of the high incidence rate of CLNM in cN0 PTC patients, we believe that routine prophylactic CLND is optimal for clinically negative PTC patients, during their first treatment, especially for those with risk factors for CLNM.
authors.affiliation: Department of Thyroid Surgery, The First Hospital of Jilin University, NO. 71 XinMin Street, Changchun, People's Republic of China.
authors.forename: Shuai
authors.initials: S
authors.lastname: Xue
authors.affiliation: Department of Thyroid Surgery, The First Hospital of Jilin University, NO. 71 XinMin Street, Changchun, People's Republic of China.
authors.forename: Peisong
authors.initials: P
authors.lastname: Wang
authors.affiliation: Department of Thyroid Surgery, The First Hospital of Jilin University, NO. 71 XinMin Street, Changchun, People's Republic of China.
authors.forename: Jia
authors.initials: J
authors.lastname: Liu
authors.affiliation: Department of Thyroid Surgery, The First Hospital of Jilin University, NO. 71 XinMin Street, Changchun, People's Republic of China.
authors.forename: Rui
authors.initials: R
authors.lastname: Li
authors.affiliation: Department of Thyroid Surgery, The First Hospital of Jilin University, NO. 71 XinMin Street, Changchun, People's Republic of China.
authors.forename: Li
authors.initials: L
authors.lastname: Zhang
authors.affiliation: Department of Thyroid Surgery, The First Hospital of Jilin University, NO. 71 XinMin Street, Changchun, People's Republic of China. Electronic address: jidayiyuanjzx@sina.com.
authors.forename: Guang
authors.initials: G
authors.lastname: Chen
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002277:Carcinoma / Q000473:pathology / Q000601:surgery*; D002291:Carcinoma, Papillary; D002681:China; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008207:Lymphatic Metastasis; D008297:Male; D008875:Middle Aged; D037981:Neck Dissection; D012189:Retrospective Studies; D012307:Risk Factors; D000077273:Thyroid Cancer, Papillary; D013964:Thyroid Neoplasms / Q000473:pathology / Q000601:surgery*; D016896:Treatment Outcome; D055815:Young Adult
keywords: lymph node metastasis; neck dissection; papillary thyroid carcinoma; risk factors