Elective central compartment neck dissection in patients with papillary thyroid carcinoma recurrence.

OBJECTIVES/HYPOTHESIS To investigate the role of elective central compartment neck dissection (CND) in patients with recurrent papillary thyroid carcinoma in the jugular chain lymph nodes. STUDY DESIGN Retrospective medical record review and analysis of survival outcomes. METHODS The study was conducted at Tel Aviv Sourasky Medical Center, Sackler School of Medicine, Tel Aviv University. Fifty-one patients who had prior thyroidectomy underwent therapeutic lateral neck dissection (LND) without radiological evidence of central neck metastases. Therapeutic LND without elective CND was performed in 17 patients, and 34 patients had elective CND. The clinical variables were similar in both groups. The median follow-up was 44 months. Disease-free survival and overall survival were the main outcome measures. RESULTS The recurrence rate in the central neck was 9% (n = 3/34) in patients undergoing CND and 12% (n = 2/17) in patients without CND. The overall recurrence rate was 18% (6/34) in patients with CND and 36% (6/17) in patients without CND (P = 0.16). The 5-year disease-free survival rate was 82% and 65% in patients with or without CND, respectively (P = 0.69). Long-term thyroglobulin levels and complication rates were similar in both groups. CONCLUSIONS The lack of significant disease-free survival advantage demonstrates the need for a prospective evaluation of the common practice of this disease.