Is the type of dissection in lateral neck metastasis for differentiated thyroid carcinoma important?

OBJECTIVE

This study was to compare the types of therapeutic neck dissection in patients with differentiated thyroid carcinoma.

STUDY DESIGN AND SETTING

Sixty-one patients with lymph node metastasis in the neck, treated between 1997 and 2001, were studied retrospectively. A comparative study was made of a selective lateral neck dissection group and a radical or modified radical neck dissection group for recurrence, disease free survival (DFS), and overall survival (OS).

RESULTS

Type of dissection was not related to DFS (P=0.92), OS (P=0.33), and local recurrence ratio (P=0.56). The factors affecting local recurrence were the age over 45 years (P=0.02), tumor size (0.005), and the presence of distant metastasis (P=0.04). The factors affecting DFS and OS were tumor size (0.003), thyroid capsule invasion (0.004).

CONCLUSIONS

Determination of the type of therapeutic neck dissection depends on patient and tumor characteristics. Selective lateral neck dissection can be applied safely in selected cases.