American Association of Endocrine SurgeonsRoutine ipsilateral level VI lymphadenectomy reduces postoperative thyroglobulin levels in papillary thyroid cancer
Section snippets
Patients and methods
A retrospective cohort study of all patients undergoing surgical intervention for PTC at the University of Sydney Endocrine Unit was undertaken. Data were retrieved from prospectively maintained surgical and nuclear medicine databases.
Results
In the period December 1995 to April 2005, 594 patients underwent surgical intervention for PTC within the University of Sydney Endocrine Surgery Unit. Of these, 447 had no preoperative evidence of lymph node metastases either in the central or lateral compartments on the basis of physical examination and sonography. Fifty-six patients underwent TT in combination with ipsilateral LNDVI and were designated as group A. Three hundred ninety-one patients in group B underwent TT alone. As shown in
Discussion
The role of routine surgery for the management of apparently normal regional lymph nodes continues to be enthusiastically debated. This is true for PTC and other surgically treated malignancies. Some groups have argued that lymph node metastasis, in general, are an indicator of prognosis rather than the determining factor of prognosis; as a result the treatment of regional lymph nodes and metastasis does not effect the outcome of cancer cases.10, 11 It has generally been accepted in the past
Conclusion
Total thyroidectomy performed in conjunction with ipsilateral LNDVI in patients with PTC and no apparent lymphadenopathy results in significantly lower levels of serum TG and higher rates of athyroglobulinemia.
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