Prophylactic neck dissection for low-risk differentiated thyroid cancers: Risk-benefit analysis.

Prophylactic neck dissection for low-risk differentiated thyroid cancers: Risk-benefit analysis.

Head Neck. 2016 Feb 13;

Authors: Dubernard X, Dabakuyo S, Ouedraogo S, Amroun K, Kere D, Nasser T, Deguelte S, Pochart JM, Merol JC, Makeieff M, Chays A, Schvartz C

Abstract
BACKGROUND: The benefit of neck dissection is the subject of debate in differentiated thyroid cancer (DTC). We analyze the risk-benefit of neck dissection for low-risk DTC without detectable lymph nodes.
METHODS: We conducted a retrospective study from 1983 to 2003; which included 295 patients without detectable lymph nodes who were treated by thyroidectomy with (C+) or without (C-) neck dissection. All patients had iodine131 therapy. We compared the frequency of remission, disease progression, and permanent complications between groups.
RESULTS: Two hundred twelve patients comprised the C+ group, and 83 patients the C- group. Respectively for C+ versus C-, remission rates were 92% versus 89.2% (p = .40), and progressive disease observed was 3.3% versus 7.2% (p = .10). Permanent hypoparathyroidism occurred in 15.1% in C+ versus 3.6% in C- (p = .006).
CONCLUSION: The risk-benefit analysis of neck dissection in patients with low-risk DTC shows no benefit in terms of complete remission or occurrence of progression. However, risk of complications seems to be higher in patients with neck dissection. © 2016 Wiley Periodicals, Inc. Head Neck, 2016.

PMID: 26873677 [PubMed - as supplied by publisher]

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