Factors affecting the adequacy of lymph node yield in prophylactic unilateral central neck dissection for papillary thyroid carcinoma.

BACKGROUND

Determinants for adequate lymph node yield (LNY) in prophylactic central neck dissection (pCND) for papillary thyroid carcinoma (PTC) remain unclear. We aimed to determine factors affecting LNY in pCND.

METHODS

Of 230 patients, 109 (47.4%) had total thyroidectomy and unilateral pCND. A specimen of ≥ 6 central lymph nodes (CLNs) was considered adequate. Factors such as patient clinicopathologic features, specimen dimensions, and pathologists' experience were compared between those with LNY  <  6 (n = 52) and LNY  ≥  6 (n  =  57). A multivariate analysis was conducted to identify independent factors for LNY ≥  6.

RESULTS

Age, sex, presentation, body mass index, tumor characteristics, TNM stages, MACIS score, and pathologist's experience were not significant determinants for LNY  ≥  6. In the univariate analysis, the length (P  =  0.021), width (P  = 0.047), thickness (P  =  0.024), and pN1a (P  =  0.042) were significant determinants but in the multivariate analysis, the length (OR  =  1.486 (95% CI: 1.053-2.097), P  =  0.024) was the only independent factor for LNY  ≥  6. Postoperative vocal cord palsy, hypoparathyroidism, stimulated thyroglobulin and recurrences were similar between LNY <6 and ≥ 6.

CONCLUSIONS

Length (or the longest measured dimension) of the fresh CLN specimen was the only factor assuring LNY ≥ 6. Surgical complications and short-term outcomes appeared similar between LNY <6 or ≥ 6.