Top

European Archives of Oto-Rhino-Laryngology

Published in:

01-07-2015 | Review Article

Impact of prophylactic central neck dissection on oncologic outcomes of papillary thyroid carcinoma: a review

Authors: Elisabeth Mamelle, Isabelle Borget, Sophie Leboulleux, Haïtham Mirghani, Carlos Suárez, Phillip K. Pellitteri, Ashok R. Shaha, Marc Hamoir, K. Thomas Robbins, Avi Khafif, Juan P. Rodrigo, Carl E. Silver, Alessandra Rinaldo, Alfio Ferlito, Dana M. Hartl

Published in: European Archives of Oto-Rhino-Laryngology | Issue 7/2015

Abstract

Prophylactic neck dissection (PND) for papillary thyroid carcinoma (PTC) is controversial. Our aim was to assess current levels of evidence (LE) according to the Oxford Centre for Evidence-based Medicine (http://www.cebm.net/?O=1025) regarding the oncologic benefits of PND. Data were analyzed via MEDLINE keywords: PTC, differentiated thyroid carcinoma, PND, central lymph node metastases, central compartment, recurrence-free survival. There was conflicting evidence regarding the rate of reoperation for recurrence, with some studies showing a lower rate after PND with increased recurrence-free survival and a higher rate of undetectable pre- and post-ablation thyroglobulin levels (LE 4), whereas other studies did not show a difference (LE 4). Only one study (LE 4) showed improved disease-specific survival with PND. PND may improve recurrence-free survival, although this is supported by only a low LE. Current recommendations can only be based on low-level evidence.

Siegel R, DeSantis C, Virgo K et al (2012) Cancer treatment and survivorship statistics, 2012. CA Cancer J Clin 62:220–241CrossRefPubMed

Siegel R, Naishadham D, Jemal A (2012) Cancer statistics, 2012. CA Cancer J Clin 62:10–29CrossRefPubMed

Podnos YD, Smith D, Wagman LD, Ellenhorn JD (2005) The implication of lymph node metastasis on survival in patients with well-differentiated thyroid cancer. Am Surg 71:731–734PubMed

Zaydfudim V, Feurer ID, Griffin MR, Phay JE (2008) The impact of lymph node involvement on survival in patients with papillary and follicular thyroid carcinoma. Surgery 144:1070–1077 (discussion 1077–1078)CrossRefPubMed

Cooper DS, Doherty GM, Haugen BR et al (2009) Revised American Thyroid Association management guidelines for patients with thyroid nodules and differentiated thyroid cancer. Thyroid 19:1167–1214CrossRefPubMed

Takami H, Ito Y, Okamoto T, Yoshida A (2011) Therapeutic strategy for differentiated thyroid carcinoma in Japan based on a newly established guideline managed by Japanese Society of Thyroid Surgeons and Japanese Association of Endocrine Surgeons. World J Surg 35:111–121CrossRefPubMed

Greene (2010) American Joint Committee on Cancer. Thyroid. In AJCC Cancer Staging Manual, 7th edn, pp 87–96

Randolph GW, Duh QY, Heller KS et al (2012) The prognostic significance of nodal metastases from papillary thyroid carcinoma can be stratified based on the size and number of metastatic lymph nodes, as well as the presence of extranodal extension. Thyroid 22:1144–1152CrossRefPubMed

Zetoune T, Keutgen X, Buitrago D et al (2010) Prophylactic central neck dissection and local recurrence in papillary thyroid cancer: a meta-analysis. Ann Surg Oncol 17:3287–3293CrossRefPubMed

10.

Barczynski M, Konturek A, Stopa M, Nowak W (2013) Prophylactic central neck dissection for papillary thyroid cancer. Br J Surg 100:410–418CrossRefPubMed

11.

Giordano D, Valcavi R, Thompson GB et al (2012) Complications of central neck dissection in patients with papillary thyroid carcinoma: results of a study on 1087 patients and review of the literature. Thyroid 22:911–917CrossRefPubMed

12.

Hartl DM, Mamelle E, Borget I et al (2013) Influence of prophylactic neck dissection on rate of retreatment for papillary thyroid carcinoma. World J Surg 37:1951–1958CrossRefPubMed

13.

Popadich A, Levin O, Lee JC et al (2011) A multicenter cohort study of total thyroidectomy and routine central lymph node dissection for cN0 papillary thyroid cancer. Surgery 150:1048–1057CrossRefPubMed

14.

Sippel RS, Chen H (2009) Controversies in the surgical management of newly diagnosed and recurrent/residual thyroid cancer. Thyroid 19:1373–1380CrossRefPubMed

15.

Carling T, Carty SE, Ciarleglio MM et al (2012) American Thyroid Association design and feasibility of a prospective randomized controlled trial of prophylactic central lymph node dissection for papillary thyroid carcinoma. Thyroid 22:237–244CrossRefPubMed

16.

Moo TA, McGill J, Allendorf J et al (2010) Impact of prophylactic central neck lymph node dissection on early recurrence in papillary thyroid carcinoma. World J Surg 34:1187–1191CrossRefPubMed

17.

Lang BH, Ng SH, Lau L et al (2013) A systematic review and meta-analysis of prophylactic central neck dissection on short-term locoregional recurrence in papillary thyroid carcinoma after total thyroidectomy. Thyroid 23:1087–1098CrossRefPubMed

18.

Hughes DT, White ML, Miller BS et al (2010) Influence of prophylactic central lymph node dissection on postoperative thyroglobulin levels and radioiodine treatment in papillary thyroid cancer. Surgery 148:1100–1106 (discussion 1006–1007)CrossRefPubMed

19.

Lang BH, Wong KP, Wan KY, Lo CY (2012) Significance of metastatic lymph node ratio on stimulated thyroglobulin levels in papillary thyroid carcinoma after prophylactic unilateral central neck dissection. Ann Surg Oncol 19:1257–1263CrossRefPubMedCentralPubMed

20.

Raffaelli M, De Crea C, Sessa L et al (2012) Prospective evaluation of total thyroidectomy versus ipsilateral versus bilateral central neck dissection in patients with clinically node-negative papillary thyroid carcinoma. Surgery 152:957–964CrossRefPubMed

21.

Wang TS, Evans DB, Fareau GG, Carroll T, Yen TW (2012) Effect of prophylactic central compartment neck dissection on serum thyroglobulin and recommendations for adjuvant radioactive iodine in patients with differentiated thyroid cancer. Ann Surg Oncol 19:4217–4222CrossRefPubMed

22.

Zhu W, Zhong M, Ai Z (2013) Systematic evaluation of prophylactic neck dissection for the treatment of papillary thyroid carcinoma. Jpn J Clin Oncol 43:883–888CrossRefPubMed

23.

Chan AC, Lang BH, Wong KP (2013) The pros and cons of routine central compartment neck dissection for clinically nodal negative (cN0) papillary thyroid cancer. Gland Surg 2:186–195PubMedCentralPubMed

24.

Bardet S, Malville E, Rame JP et al (2008) Macroscopic lymph-node involvement and neck dissection predict lymph-node recurrence in papillary thyroid carcinoma. Eur J Endocrinol 158:551–560CrossRefPubMed

25.

Choi SJ, Lee TY, Lee JC et al (2008) Is routine central neck dissection necessary for the treatment of papillary thyroid microcarcinoma? Clin Exp Otorhinolaryngol 1:41–45CrossRefPubMedCentralPubMed

26.

Perrino M, Vannucchi G, Vicentini L et al (2009) Outcome predictors and impact of central node dissection and radiometabolic treatments in papillary thyroid cancers ≤2 cm. Endocr Relat Cancer 16:201–210CrossRefPubMed

27.

Costa S, Giugliano G, Santoro L et al (2009) Role of prophylactic central neck dissection in cN0 papillary thyroid cancer. Acta Otorhinolaryngol Ital 29:61–69PubMedCentralPubMed

28.

Wang TS, Cheung K, Farrokhyar F, Roman SA, Sosa JA (2013) A meta-analysis of the effect of prophylactic central compartment neck dissection on locoregional recurrence rates in patients with papillary thyroid cancer. Ann Surg Oncol 20:3477–3483CrossRefPubMed

29.

Cranshaw IM, Carnaille B (2008) Micrometastases in thyroid cancer. An important finding? Surg Oncol 17:253–258CrossRefPubMed

30.

Ito Y, Tomoda C, Uruno T et al (2004) Preoperative ultrasonographic examination for lymph node metastasis: usefulness when designing lymph node dissection for papillary microcarcinoma of the thyroid. World J Surg 28:498–501CrossRefPubMed

31.

Hartl DM, Leboulleux S, Al Ghuzlan A et al (2012) Optimization of staging of the neck with prophylactic central and lateral neck dissection for papillary thyroid carcinoma. Ann Surg 255:777–783CrossRefPubMed

32.

Zuniga S, Sanabria A (2009) Prophylactic central neck dissection in stage N0 papillary thyroid carcinoma. Arch Otolaryngol Head Neck Surg 135:1087–1091CrossRefPubMed

33.

Pacini F, Molinaro E, Castagna MG et al (2003) Recombinant human thyrotropin-stimulated serum thyroglobulin combined with neck ultrasonography has the highest sensitivity in monitoring differentiated thyroid carcinoma. J Clin Endocrinol Metab 88:3668–3673CrossRefPubMed

34.

Roh JL, Park JY, Park CI (2007) Total thyroidectomy plus neck dissection in differentiated papillary thyroid carcinoma patients: pattern of nodal metastasis, morbidity, recurrence, and postoperative levels of serum parathyroid hormone. Ann Surg 245:604–610CrossRefPubMedCentralPubMed

35.

So YK, Seo MY, Son YI (2012) Prophylactic central lymph node dissection for clinically node-negative papillary thyroid microcarcinoma: influence on serum thyroglobulin level, recurrence rate, and postoperative complications. Surgery 151:192–198CrossRefPubMed

36.

Sywak M, Cornford L, Roach P et al (2006) Routine ipsilateral level VI lymphadenectomy reduces postoperative thyroglobulin levels in papillary thyroid cancer. Surgery 140:1000–1005 (discussion 1005–1007)CrossRefPubMed

37.

Brassard M, Borget I, Edet-Sanson A et al (2011) Long-term follow-up of patients with papillary and follicular thyroid cancer: a prospective study on 715 patients. J Clin Endocrinol Metab 96:1352–1359CrossRefPubMed

38.

Schlumberger M, Catargi B, Borget I et al (2012) Strategies of radioiodine ablation in patients with low-risk thyroid cancer. N Engl J Med 366:1663–1673CrossRefPubMed

39.

Tuttle RM, Rondeau G, Lee NY (2011) A risk-adapted approach to the use of radioactive iodine and external beam radiation in the treatment of well-differentiated thyroid cancer. Cancer Control 18:89–95PubMed

40.

Gyorki DE, Untch B, Tuttle RM, Shaha AR (2013) Prophylactic central neck dissection in differentiated thyroid cancer: an assessment of the evidence. Ann Surg Oncol 20:2285–2289CrossRefPubMed

41.

Tuttle RM, Tala H, Shah J et al (2010) Estimating risk of recurrence in differentiated thyroid cancer after total thyroidectomy and radioactive iodine remnant ablation: using response to therapy variables to modify the initial risk estimates predicted by the new American Thyroid Association staging system. Thyroid 20:1341–1349CrossRefPubMed

42.

Glover AR, Gundara JS, Norlen O, Lee JC, Sidhu SB (2013) The pros and cons of prophylactic central neck dissection in papillary thyroid carcinoma. Gland Surg 2:196–205PubMedCentralPubMed

43.

Nascimento C, Borget I, Al Ghuzlan A et al (2011) Persistent disease and recurrence in differentiated thyroid cancer patients with undetectable postoperative stimulated thyroglobulin level. Endocr Relat Cancer 18:R29–R40PubMed

44.

Conzo G, Docimo G, Pasquali D et al (2013) Predictive value of nodal metastases on local recurrence in the management of differentiated thyroid cancer. Retrospective clinical study. BMC Surg 13(Suppl 2):S3CrossRefPubMedCentralPubMed

45.

Moreno MA, Edeiken-Monroe BS, Siegel ER, Sherman SI, Clayman GL (2012) In papillary thyroid cancer, preoperative central neck ultrasound detects only macroscopic surgical disease, but negative findings predict excellent long-term regional control and survival. Thyroid 22:347–355CrossRefPubMedCentralPubMed

46.

Shindo M, Wu JC, Park EE, Tanzella F (2006) The importance of central compartment elective lymph node excision in the staging and treatment of papillary thyroid cancer. Arch Otolaryngol Head Neck Surg 132:650–654CrossRefPubMed

47.

Wu LM, Gu HY, Qu XH et al (2012) The accuracy of ultrasonography in the preoperative diagnosis of cervical lymph node metastasis in patients with papillary thyroid carcinoma: a meta-analysis. Eur J Radiol 81:1798–1805CrossRefPubMed

48.

Choi JS, Kim J, Kwak JY et al (2009) Preoperative staging of papillary thyroid carcinoma: comparison of ultrasound imaging and CT. AJR Am J Roentgenol 193:871–878CrossRefPubMed

49.

Morita S, Mizoguchi K, Suzuki M, Iizuka K (2010) The accuracy of (18)[F]-fluoro-2-deoxy-d-glucose-positron emission tomography/computed tomography, ultrasonography, and enhanced computed tomography alone in the preoperative diagnosis of cervical lymph node metastasis in patients with papillary thyroid carcinoma. World J Surg 34:2564–2569CrossRefPubMed

50.

Mulla MG, Knoefel WT, Gilbert J, McGregor A, Schulte KM (2012) Lateral cervical lymph node metastases in papillary thyroid cancer: a systematic review of imaging-guided and prophylactic removal of the lateral compartment. Clin Endocrinol (Oxf) 77:126–131CrossRef

51.

Roh JL, Park JY, Kim JM, Song CJ (2009) Use of preoperative ultrasonography as guidance for neck dissection in patients with papillary thyroid carcinoma. J Surg Oncol 99:28–31CrossRefPubMed

52.

Leboulleux S, Rubino C, Baudin E et al (2005) Prognostic factors for persistent or recurrent disease of papillary thyroid carcinoma with neck lymph node metastases and/or tumor extension beyond the thyroid capsule at initial diagnosis. J Clin Endocrinol Metab 90:5723–5729CrossRefPubMed

53.

Bonnet S, Hartl D, Leboulleux S et al (2009) Prophylactic lymph node dissection for papillary thyroid cancer less than 2 cm: implications for radioiodine treatment. J Clin Endocrinol Metab 94:1162–1167CrossRefPubMed

54.

Balasubramanian SP, Harrison BJ (2011) Systematic review and meta-analysis of sentinel node biopsy in thyroid cancer. Br J Surg 98:334–344CrossRefPubMed

55.

Ito Y, Tsushima Y, Masuoka H et al (2011) Significance of prophylactic modified radical neck dissection for patients with low-risk papillary thyroid carcinoma measuring 1.1–3.0 cm: first report of a trial at Kuma Hospital. Surg Today 41:1486–1491CrossRefPubMed

56.

Eun YG, Lee YC, Kwon KH (2014) Predictive factors of contralateral paratracheal lymph node metastasis in papillary thyroid cancer: prospective multicenter study. Otolaryngol Head Neck Surg 150:210–215CrossRefPubMed

57.

Chae BJ, Jung CK, Lim DJ et al (2011) Performing contralateral central lymph node dissection in papillary thyroid carcinoma: a decision approach. Thyroid 21:873–877CrossRefPubMed

58.

Moo TA, Umunna B, Kato M et al (2009) Ipsilateral versus bilateral central neck lymph node dissection in papillary thyroid carcinoma. Ann Surg 250:403–408PubMed

59.

Raffaelli M, De Crea C, Sessa L et al (2013) Can intraoperative frozen section influence the extension of central neck dissection in cN0 papillary thyroid carcinoma? Langenbecks Arch Surg 398:383–388CrossRefPubMed

60.

Koo BS, Choi EC, Yoon YH et al (2009) Predictive factors for ipsilateral or contralateral central lymph node metastasis in unilateral papillary thyroid carcinoma. Ann Surg 249:840–844CrossRefPubMed

61.

Alvarado R, Sywak MS, Delbridge L, Sidhu SB (2009) Central lymph node dissection as a secondary procedure for papillary thyroid cancer: is there added morbidity? Surgery 145:514–518CrossRefPubMed

62.

Shen WT, Ogawa L, Ruan D et al (2010) Central neck lymph node dissection for papillary thyroid cancer: comparison of complication and recurrence rates in 295 initial dissections and reoperations. Arch Surg 145:272–275CrossRefPubMed

63.

Kim WW, Park HY, Jung JH (2013) Surgical extent of central lymph node dissection in clinically node-negative papillary thyroid cancer. Head Neck 35:1616–1620CrossRefPubMed

64.

Lee YS, Lim YS, Lee JC et al (2010) Clinical implication of the number of central lymph node metastasis in papillary thyroid carcinoma: preliminary report. World J Surg 34:2558–2563CrossRefPubMed

65.

Lombardi CP, Bellantone R, De Crea C et al (2010) Papillary thyroid microcarcinoma: extrathyroidal extension, lymph node metastases, and risk factors for recurrence in a high prevalence of goiter area. World J Surg 34:1214–1221CrossRefPubMed

66.

So YK, Son YI, Hong SD et al (2010) Subclinical lymph node metastasis in papillary thyroid microcarcinoma: a study of 551 resections. Surgery 148:526–531CrossRefPubMed

67.

Teixeira G, Teixeira T, Gubert F, Chikota H, Tufano R (2011) The incidence of central neck micrometastatic disease in patients with papillary thyroid cancer staged preoperatively and intraoperatively as N0. Surgery 150:1161–1167CrossRefPubMed

68.

Tufano RP, Teixeira GV, Bishop J, Carson KA, Xing M (2012) BRAF mutation in papillary thyroid cancer and its value in tailoring initial treatment: a systematic review and meta-analysis. Medicine (Baltimore) 91:274–286CrossRef

69.

Lang BH, Chai YJ, Cowling BJ et al (2014) Is BRAFV600E mutation a marker for central nodal metastasis in small papillary thyroid carcinoma? Endocr Relat Cancer 21:285–295CrossRefPubMed

70.

Pitoia F, Ward L, Wohllk N et al (2009) Recommendations of the Latin American Thyroid Society on diagnosis and management of differentiated thyroid cancer. Arq Bras Endocrinol Metabol 53:884–887CrossRefPubMed

71.

Sancho JJ, Lennard TW, Paunovic I, Triponez F, Sitges-Serra A (2014) Prophylactic central neck dissection in papillary thyroid cancer: a consensus report of the European Society of Endocrine Surgeons (ESES). Langenbecks Arch Surg 399:155–163CrossRefPubMed

72.

Pacini F, Schlumberger M, Dralle H et al (2006) European consensus for the management of patients with differentiated thyroid carcinoma of the follicular epithelium. Eur J Endocrinol 154:787–803CrossRefPubMed

73.

(2010) Thyroid Carcinoma. 2nd edn. NCCN Guidelines, pp 1–104. Available online: http://www.nccn.org/professionals/physician_gls/pdf/thyroid.pdf. Accessed 25/8/2013

74.

Pacini F, Castagna MG, Brilli L, Pentheroudakis G; ESMO Guidelines Working Group (2012) Thyroid cancer: ESMO Clinical Practice Guidelines for diagnosis, treatment and follow-up. Ann Oncol 23(Suppl 7):vii110–vii119

Title: Impact of prophylactic central neck dissection on oncologic outcomes of papillary thyroid carcinoma: a review
Authors: Elisabeth Mamelle
Isabelle Borget
Sophie Leboulleux
Haïtham Mirghani
Carlos Suárez
Phillip K. Pellitteri
Ashok R. Shaha
Marc Hamoir
K. Thomas Robbins
Avi Khafif
Juan P. Rodrigo
Carl E. Silver
Alessandra Rinaldo
Alfio Ferlito
Dana M. Hartl
Publication date: 01-07-2015
Publisher: Springer Berlin Heidelberg
Published in: European Archives of Oto-Rhino-Laryngology / Issue 7/2015
Print ISSN: 0937-4477
Electronic ISSN: 1434-4726
DOI: https://doi.org/10.1007/s00405-014-3104-5

At a glance: The STEP trials

Springer Medicine

Impact of prophylactic central neck dissection on oncologic outcomes of papillary thyroid carcinoma: a review

Abstract

At a glance: The STEP trials

Springer Medicine

Abstract

Please log in to get access to this content

Other articles of this Issue 7/2015

Clinical implication of ocular torsion in peripheral vestibulopathy

Expression of podoplanin and prognosis in oropharyngeal cancer

Human papilloma virus and survival of oropharyngeal cancer patients treated with surgery and adjuvant radiotherapy

Caudal extension graft versus columellar strut with plumping graft for acute nasolabial angle correction in rhinoplasty surgery

Erratum to: Reliability and validity of the Nijmegen Cochlear Implant Questionnaire in Spanish

Comparative analysis of Cutanplast and Spongostan nasal packing after endoscopic sinus surgery: a prospective, randomized, multicenter study