Clinical Analysis on Optimized Surgical Approach for Clinical Stage N_0 Papillary Thyroid Carcinoma

Objective: To investigate the selection of surgical operation for clinical stage N0 (cN0) papillary thyroid carcinoma (PTC). Methods:The clinical data of 127 patients of PTC with cN0 from January 2007 to January 2010 were analyzed. According to the preoperativeclinicalstaging andpathological staging of intraoperative frozen, 113 cases underwent selective cervical lymphadenectomy, 44 cases with central lymph node dissection, 13 cases with the expanded central lymph node dissection and 56 cases with the functional neck lymph node dissection. The differences between various sets of lymph nodes metastasis data were compared between groups. Results: In 113 cases,30.1% (34/113) of all cases showed implicit lymph nodes metastasis. There were significant differences in lymph node metastasis (Ⅵ area) between different extents of tumor invasion and different age groups (P 0.05). There were no significant differences between lymph node metastasis, gender and body mass index (BMI) (P 0.05). The lymph node metastasis rate (Ⅱ-Ⅳ area) was significantly correlated with the lymph node metastasis (Ⅵ area) (r = 0.610,P 0.01). Conclusion: Patients with cN0 PTC should be performed the central lymph node dissection. Furthermore, the expanded central lymph node dissection should be performed in patients at high risk for lymph node metastasis.