| The Role of Prophylactic Central Neck Dissection in Clinically Node-Negative T3/T4 Papillary Thyroid Carcinoma |
Hyeon A Lee
, Ha Gyeong Lee
, Chang Myeon Song
, Kyung Tae
, Yong Bae Ji
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| Department of Otolaryngology-Head and Neck Surgery, College of Medicine, Hanyang University, Seoul, Korea |
| 임상적 전이가 없는 T3, T4 갑상선 유두암 환자에서의 예방적 중심 경부 림프절 절제술 역할 |
| 이현아
, 이하경
, 송창면
, 태경
, 지용배
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| 한양대학교 의과대학 이비인후-두경부외과학교실 |
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Received: 12 March 2026; Revised: April 24, 2026 Accepted: 6 May 2026. Published online: 15 July 2026. |
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| ABSTRACT |
Background and Objectives
The necessity of prophylactic central neck dissection (pCND) in papillary thyroid carcinoma (PTC) remains controversial. This study aimed to investigate the significance of pCND in T3/T4 PTC and evaluate its impact on recurrence and postoperative complications.
Subjects and Method
We retrospectively analyzed 1050 patients with clinically node-negative (cN0) PTC who underwent total thyroidectomy with or without pCND between 1995 and 2022. Occult lymph node metastasis, recurrence, and postoperative complications were evaluated. Among the patients, 950 had the T1/T2 disease and 100 had the T3/T4 disease. pCND was performed in 78.9% of the T1/T2 group and 83.0% of the T3/T4 group.
Results
Among patients who underwent pCND, occult lymph node metastasis was identified in 37.1% of the T1/T2 group and 43.4% of the T3/T4 group, without significant differences. In both cN0 T1-T4 cohort and the cN0 T3/T4 subgroup, the multivariate Cox regression analysis showed that pCND was not associated with recurrence. In the cN0 T3/T4 group, recurrence occurred in four patients who underwent pCND (4.8%) and in one patient who did not (5.9%), showing no significant difference. There was no central lymph node recurrence; all recurrences observed occurred in the lateral lymph nodes. Transient hypoparathyroidism was significantly higher in the pCND group (p=0.015), but there was no significant difference found in the recurrent laryngeal nerve palsy.
Conclusion
The role of pCND may be limited even in cN0 T3/T4 PTC. Recurrence rates did not differ significantly according to pCND, while transient hypoparathyroidism occurred more frequently in the pCND group. |
| Keywords:
Lymph nodeㆍ Lymphatic metastasisㆍ Neck dissectionㆍ Papillary thyroid cancerㆍ Recurrence |
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