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Performing Central Neck Dissection in Patients with Papillary Thyroid Carcinoma with Clinically Node Negative, Benefits and Drawbacks: A Comparative Study

Received: 28 April 2020     Accepted: 20 May 2020     Published: 4 June 2020
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Abstract

Context: central neck dissection in addition to total thyroidectomy as a management procedure of patients with papillary carcinoma of the thyroid [PTC] was previously found to decrease the incidence of lymph node recurrence and allow and accurate PTC surgical staging that allow making a better decision regarding adjuvant radioactive iodine (RAI) ablation. But recently, central neck dissection in patients with clinical and radiological evidences of negative cervical lymph nodes was found to have many post-operative complications. Aim: to assess benefits, complications and drawbacks of performing central neck dissection by in PTC patients. Patients and methods: This is a prospective randomized study which included 70 PTC patients who was subjected to total thyroidectomy with or without neck dissection; all included patients have clinically negative cervical lymph nodes, 40 (60%) underwent total thyroidectomy in addition to central neck dissection and 30 (40%) patients were subjected to only total thyroidectomy without central neck dissection. We followed our patients for five years to detect recurrence, RFS and OS rates. Results: We found that operative time was longer in patients underwent central block dissection (p=0.049). Recurrence free survival and overall survival rates were not significantly different among both included groups, which denoted that central block neck dissection has no survival benefits in PTC patients. Conclusions: We have concluded that performing central neck dissection in PTC with clinically and radiologically negative lymph nodes has no benefits in increasing patients’ survival or decreasing recurrence rate and might lead to prolongation of operation time, increasing post-operative morbidity.

Published in Journal of Surgery (Volume 8, Issue 3)
DOI 10.11648/j.js.20200803.13
Page(s) 90-96
Creative Commons

This is an Open Access article, distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution and reproduction in any medium or format, provided the original work is properly cited.

Copyright

Copyright © The Author(s), 2020. Published by Science Publishing Group

Keywords

Central Neck Dissection, Papillary Thyroid Carcinoma, Recurrence, Survival

References
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Cite This Article
  • APA Style

    Ibtsam Shehta Harera, Gamal Osman, Rehab Hemeda, Shady Emad Shaker, Mohamed Abdallah Zaitoun. (2020). Performing Central Neck Dissection in Patients with Papillary Thyroid Carcinoma with Clinically Node Negative, Benefits and Drawbacks: A Comparative Study. Journal of Surgery, 8(3), 90-96. https://doi.org/10.11648/j.js.20200803.13

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    ACS Style

    Ibtsam Shehta Harera; Gamal Osman; Rehab Hemeda; Shady Emad Shaker; Mohamed Abdallah Zaitoun. Performing Central Neck Dissection in Patients with Papillary Thyroid Carcinoma with Clinically Node Negative, Benefits and Drawbacks: A Comparative Study. J. Surg. 2020, 8(3), 90-96. doi: 10.11648/j.js.20200803.13

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    AMA Style

    Ibtsam Shehta Harera, Gamal Osman, Rehab Hemeda, Shady Emad Shaker, Mohamed Abdallah Zaitoun. Performing Central Neck Dissection in Patients with Papillary Thyroid Carcinoma with Clinically Node Negative, Benefits and Drawbacks: A Comparative Study. J Surg. 2020;8(3):90-96. doi: 10.11648/j.js.20200803.13

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  • @article{10.11648/j.js.20200803.13,
      author = {Ibtsam Shehta Harera and Gamal Osman and Rehab Hemeda and Shady Emad Shaker and Mohamed Abdallah Zaitoun},
      title = {Performing Central Neck Dissection in Patients with Papillary Thyroid Carcinoma with Clinically Node Negative, Benefits and Drawbacks: A Comparative Study},
      journal = {Journal of Surgery},
      volume = {8},
      number = {3},
      pages = {90-96},
      doi = {10.11648/j.js.20200803.13},
      url = {https://doi.org/10.11648/j.js.20200803.13},
      eprint = {https://article.sciencepublishinggroup.com/pdf/10.11648.j.js.20200803.13},
      abstract = {Context: central neck dissection in addition to total thyroidectomy as a management procedure of patients with papillary carcinoma of the thyroid [PTC] was previously found to decrease the incidence of lymph node recurrence and allow and accurate PTC surgical staging that allow making a better decision regarding adjuvant radioactive iodine (RAI) ablation. But recently, central neck dissection in patients with clinical and radiological evidences of negative cervical lymph nodes was found to have many post-operative complications. Aim: to assess benefits, complications and drawbacks of performing central neck dissection by in PTC patients. Patients and methods: This is a prospective randomized study which included 70 PTC patients who was subjected to total thyroidectomy with or without neck dissection; all included patients have clinically negative cervical lymph nodes, 40 (60%) underwent total thyroidectomy in addition to central neck dissection and 30 (40%) patients were subjected to only total thyroidectomy without central neck dissection. We followed our patients for five years to detect recurrence, RFS and OS rates. Results: We found that operative time was longer in patients underwent central block dissection (p=0.049). Recurrence free survival and overall survival rates were not significantly different among both included groups, which denoted that central block neck dissection has no survival benefits in PTC patients. Conclusions: We have concluded that performing central neck dissection in PTC with clinically and radiologically negative lymph nodes has no benefits in increasing patients’ survival or decreasing recurrence rate and might lead to prolongation of operation time, increasing post-operative morbidity.},
     year = {2020}
    }
    

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  • TY  - JOUR
    T1  - Performing Central Neck Dissection in Patients with Papillary Thyroid Carcinoma with Clinically Node Negative, Benefits and Drawbacks: A Comparative Study
    AU  - Ibtsam Shehta Harera
    AU  - Gamal Osman
    AU  - Rehab Hemeda
    AU  - Shady Emad Shaker
    AU  - Mohamed Abdallah Zaitoun
    Y1  - 2020/06/04
    PY  - 2020
    N1  - https://doi.org/10.11648/j.js.20200803.13
    DO  - 10.11648/j.js.20200803.13
    T2  - Journal of Surgery
    JF  - Journal of Surgery
    JO  - Journal of Surgery
    SP  - 90
    EP  - 96
    PB  - Science Publishing Group
    SN  - 2330-0930
    UR  - https://doi.org/10.11648/j.js.20200803.13
    AB  - Context: central neck dissection in addition to total thyroidectomy as a management procedure of patients with papillary carcinoma of the thyroid [PTC] was previously found to decrease the incidence of lymph node recurrence and allow and accurate PTC surgical staging that allow making a better decision regarding adjuvant radioactive iodine (RAI) ablation. But recently, central neck dissection in patients with clinical and radiological evidences of negative cervical lymph nodes was found to have many post-operative complications. Aim: to assess benefits, complications and drawbacks of performing central neck dissection by in PTC patients. Patients and methods: This is a prospective randomized study which included 70 PTC patients who was subjected to total thyroidectomy with or without neck dissection; all included patients have clinically negative cervical lymph nodes, 40 (60%) underwent total thyroidectomy in addition to central neck dissection and 30 (40%) patients were subjected to only total thyroidectomy without central neck dissection. We followed our patients for five years to detect recurrence, RFS and OS rates. Results: We found that operative time was longer in patients underwent central block dissection (p=0.049). Recurrence free survival and overall survival rates were not significantly different among both included groups, which denoted that central block neck dissection has no survival benefits in PTC patients. Conclusions: We have concluded that performing central neck dissection in PTC with clinically and radiologically negative lymph nodes has no benefits in increasing patients’ survival or decreasing recurrence rate and might lead to prolongation of operation time, increasing post-operative morbidity.
    VL  - 8
    IS  - 3
    ER  - 

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Author Information
  • General Surgery Department, Faculty of Medicine, Zagazig University, Zagazig, Egypt

  • General Surgery Department, Faculty of Medicine, Zagazig University, Zagazig, Egypt

  • Clinical Oncology and Nuclear Medicine Department, Zagazig University, Zagazig, Egypt

  • Internal Medicine Department, Faculty of Medicine, Zagazig University, Zagazig, Egypt

  • General Surgery Department, Faculty of Medicine, Zagazig University, Zagazig, Egypt

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