Central neck dissection in papillary thyroid carcinoma: results of a retrospective study.

Aims of the study: The aim of this retrospective study was to appraise the impact of central neck dissection (CND) when treating papillary thyroid carcinoma (PTC) and identifying predictors of tumour recurrence by analysing the results and complications related to this surgical procedure. Materials and methods: The study examined the histories of 347 patients with PTC, divided into two groups: group A including 284 patients who underwent total thyroidectomy (TT) only; group B including 63 patients who underwent TT and CND and possible lateral neck dissection (LND). Results: The patients in the B group were younger than those in the A group (an average of 44.5 vs. 48.6; p ¼ 0.03) and their tumours were larger (1.91 cm vs 1.27 cm, p ¼ 0.001). Multifocality, extra-capsular extensions of the neoplastic mass and high cell histological variant were more prevalent in the B group. The incidence of permanent hyperparathyroidism was higher in group B than in group A (25.4% vs 9.5%, p ¼ 0.0006). Recurrence of disease and the numbers requiring reoperation were also higher in group B: (24.1% in group B vs 6.6 in group A, p < 0.0001). Patients classified as clinically N0 at their first operation and who were most probably clinically N1, totalled 6.6%. Conclusions: Our data show that only extra-capsular extension may be considered a predictor of recurrence. The findings of our study support the idea of carrying out “therapeutic” CND only in cases of preoperative or macroscopic intraoperative clinical evidence of lymph-node involvement.