McHenry Christopher R, Stulberg Jonah J
Department of Surgery, MetroHealth Medical Center, Case Western Reserve University School of Medicine, 2500 MetroHealth Drive, Cleveland, OH 44109, USA.
Department of Surgery, University Hospitals, Case Medical Center, 11100 Euclid Avenue, Cleveland, OH 44106, USA.
Surg Clin North Am. 2014 Jun;94(3):529-40. doi: 10.1016/j.suc.2014.02.003. Epub 2014 Apr 4.
Prophylactic central compartment neck dissection (pCCND) is a CCND in patients with thyroid cancer who have no clinical, sonographic, or intraoperative evidence of abnormal lymph nodes. Whether pCCND should be performed in all patients with clinically node-negative papillary thyroid cancer (PTC) is controversial. Existing data reveal that for patients with clinically node-negative PTC there is no difference between treatment with total thyroidectomy plus pCCND and total thyroidectomy alone. The potential increased risk of hypoparathyroidism associated with CCND is not offset by any measurable oncologic benefit. Risk/benefit balance favors total thyroidectomy alone for patients with clinically node-negative PTC.
预防性中央区颈部淋巴结清扫术(pCCND)是指对没有临床、超声或术中异常淋巴结证据的甲状腺癌患者进行的颈部淋巴结清扫术。对于所有临床淋巴结阴性的乳头状甲状腺癌(PTC)患者是否都应进行pCCND存在争议。现有数据表明,对于临床淋巴结阴性的PTC患者,全甲状腺切除术加pCCND与单纯全甲状腺切除术治疗之间没有差异。与颈部淋巴结清扫术相关的甲状旁腺功能减退症潜在增加的风险并未被任何可测量的肿瘤学益处所抵消。对于临床淋巴结阴性的PTC患者,风险/获益平衡有利于单纯全甲状腺切除术。