9th Biennial Congress of the European Society of Endocrine Surgeons, Athens, Greece, 26 - 28 May 2022, vol.1, pp.1
Background To evaluate the effects of ipsilateral prophylactic lymph node dissection(PCLND) on surgical outcomes and radioactive Iodine(RAI) treatment rates in clinically node negative patients with papillary thyroid carcinoma(PTC). Method Data of 718 patients, who underwent surgery for PTC between January 2010 and December 2020 were evaluated retrospectively. Of these 718 patients, 274(38.2%) underwent total thyroidectomy (TT) and ipsilateral PCLND(Group 1) and 444(61.8%) underwent TT(Group 2). Demographic and histopathologic features, postoperative stimulated thyroglobulin (sTg) levels, lymph node (LN) status , local recurrence, adjuvant RAI treatment rates and response to treatment were compared between the two groups. Results Demographic data showed no significant difference between the groups. Tumor size were similar in both groups (16.1±10.4mmvs15.4±12.5mm,p=0.4). Aggressive histopathological subtypes were more frequent in Group 1 compared to Group 2 (7.2%vs3.8%,p=0.03). Postoperative sTg values were similar in both groups (7.5±57.5vs6.7±31.6,p=0.1). Local recurrence rates showed no difference between the two groups (0,018%vs40,01%,p=0.2). Adjuvant RAI rate was significantly higher in group1 compared to group 2 (263(74%)vs 259(58%),p=0.001). Central LN metastasis was detected in 79(%28) patients in Group 1 and incidentally found in 7(0.1%) patients in group 2. The rate of excellent response to treatment showed no significant difference between the two groups (95.6% vs 96.3%). Conclusion Ipsilateral PCLND does not have any impact on local recurrence rates and excellent response to treatment in clinically N0 PTC patients but it results in increased rates of RAI treatment.