Impact of Routine Unilateral Central Neck Dissection on Preablative and Postablative Stimulated Thyroglobulin Levels after Total Thyroidectomy in Papillary Thyroid Carcinoma

摘要: Prophylactic central neck dissection (CND) remains controversial in papillary thyroid carcinoma (PTC). Because postsurgical stimulated thyroglobulin (sTg) level is a good surrogate for recurrence, the study aimed to evaluate impact of prophylactic CND on preablative and postablative sTg levels after total thyroidectomy. Of 185 patients retrospectively analyzed, 82 (44.3%) underwent thyroidectomy (CND-positive group) while 103 (55.7%) only (CND-negative group). All had no preoperative or intraoperative evidence lymph node metastases. Clinicopathological characteristics, postoperative outcomes, were compared between two groups. Preablative was taken at time radioiodine ablation, 6 months ablation. A multivariable analysis conducted identify factors athyroglobulinemia (sTg < 0.5 μg/L). Relative CND-negative group, CND-positive group larger tumors (15 mm vs. 10 mm, P < 0.005), more extrathyroidal extension (26.8% 14.6%, P < 0.003), tumor, node, metastasis system stage III disease (32.9% 9.7%, P < 0.001), temporary hypoparathyroidism (18.3% 8.7%, P = 0.017). Fourteen (17.1%) upstaged from stages I/II as result CND. The experienced lower median (<0.5 μg/L 6.7 μg/L, P < 0.001) higher rate (51.2% 22.3%, P = 0.024), but these differences not observed independent factor athyroglobulinemia. Although performing may offer complete initial tumor resection than alone by minimizing any residual microscopic disease, such difference becomes less noticeable