Session: OR14-Thyroid Cancer: Insights into Diagnosis & Treatment
Room 103 (Moscone Center)
The aim of this prospective randomized controlled study was to evaluate the advantages and disadvantages of pCCND, in particular: the outcome, the rate of surgical complications and the possible predictors of central compartment lymph node metastases of DTC pts treated with either total thyroidectomy (TTx) or TTx and pCCND.
A total of 169 DTC pts without evidence of preoperative/intraoperative lymph node metastases (N0) were randomly assigned to TTx, (Group-A, n=84) or TTx with pCCND (Group-B, n=85).
The two groups did not differ for the epidemiological and clinical-pathological features but, as expected, only from a high prevalence of microscopic central compartment lymph node metastases (N1a) in Group-B (50%). After a mean follow-up of 3.5 years no difference was observed in the outcome of the two groups. Group-A pts were treated with a higher number of 131I courses (p=0.0017) than Group-B while a higher prevalence of permanent hypoparathyroidism was observed in Group-B (p=0.046). Among Group-B, N1a pts had a higher prevalence of extrathyroid extension (p=0.002) and advanced stage (p=0.046), no other predictors of central compartment lymph node metastases were found. Moreover pCCND “upstaged” 3.5% of pts and in 1.2% affected radioiodine treatment decision.
In conclusion no preoperative features of DTC could suggest for or against central compartment lymph node dissection. Total thyroidectomy alone was as effective as total thyroidectomy with prophylactic central compartment lymph node dissection with a lower rate of surgical complications but the necessity of a higher number or radioiodine courses. Neck dissection will increase the number of patients that according to the European and American guidelines need to be treated with radioiodine.
Nothing to Disclose: DV, LV, PF, EM, ES, LA, GM, FB, PM, PV, RE
*Please take note of The Endocrine Society's News Embargo Policy at http://www.endo-society.org/endo2013/media.cfm
See more of: Abstracts - Orals, Featured Poster Presentations, and Posters