Objectives:

The study aimed to investigate the effectiveness and complication rate of central lymph node dissection in patients with papillary thyroid cancer for whom prophylactic central lymph node dissection (pSLND) is not recommended according to treatment guidelines.

Materials and Methods:

Ninety-one patients with papillary thyroid cancer who underwent SLND in addition to thyroid surgery performed in a single institution and by a single surgeon were included in the study. The patients were divided into two groups according to the guideline recommendations as SLND recommended (n=42) and pSLND not recommended (n=49). The groups were compared among themselves and also in terms of preoperative and postoperative evaluation results.

Results:

The findings indicated that patients for whom pSLND was not recommended had a 34.7% rate of central lymph node metastasis. Additionally, 17.9% of all patients had a change in SLND indication in the postoperative evaluation. There was no significant difference in the rate of extrathyroidal extension or capsule invasion between the groups. However, the rate of transient hypoparathyroidism was significantly higher in the SLND recommended group (p=0.032). When the preoperative and postoperative evaluation results of all patients were compared, it was observed that there was a significant difference between multicentricity, capsule and extrathyroidal invasion, and metastatic lymph node counts (p<0.05).

Conclusion:

In conclusion, it is thought that treatment guideline recommendations should be evaluated in parallel with the volume of centers and surgical experience, so that more pSLND can be applied in patients with cN0 thyroid cancer, with similar complication rates, better locoregional recurrence control, and therefore better disease-free survival and quality of life.

Keywords: Thyroid Cancer, Thyroidectomy, Lymph Node Dissection