Clinical significance of central lymph node dissection for papillary thyroid carcinoma

[Objective] To investigate the significance of the central group neck dissection for papillary thyroid carcinoma.[Methods] Clinical data of papillary thyroid carcinoma,in 61 cases diagnosed by surgery from March 2007 to February 2010 were analyzed retrospectively,among which there were 36 cases of anterior cervical region painless mass on admission,5 cases of cervical lymph node enlargement,2 cases of hoarseness,18 cases of thyroid nodules revealed by physical examination.Forty-six cases received total affected thyroidectomy plus isthmus and opposite subtotal thyroidectomy and 15 cases took total thyroidecyomy.Three cases were treated with radical lymph node dissection,26 cases were performed with functional lymph node dissection,and 32 cases obtained selective lymph node dissection.[Results] Unilateral papillary thyroid carcinoma was found in 47 cases,bilateral in 11 cases and isthmus in 3 cases.The total rates of cervical lymph node metastasis were 26.6%(136/511).Metastasis rate of central group lymph node was higher obviously than those of lateral group,no matter how tumor size,whether extrathyroid tumor invasion and precervical muscle invasion were or not(P0.05).Metastasis rates of lymph node in both central and lateral groups were high significantly when tumor diameter was more than 1.0cm and invasion thyroid capsule and invasion precervical muscle were appeared(P0.05).One case was temporary recurrent laryngeal never injury and recovered in 4 months.Four cases were temporary hypoparathyroidism and no permanent hypoparathyroidism occurred.The tumor in 3 cases reoccurred locally in 0.5~3 years and was re-operated.There was no death case.[Conclusion] Metastasis of central group neck lymph node with papillary thyroid carcinoma was higher than lateral group lymph node.Central group neck lymph node dissection should be performed routinely for clinical N1 patients.Central group neck lymph node dissection for clinical N0 should be performed meanwhile initial surgical treatment.