EP106 – Extent of central lymph node dissection for papillary thyroid carcinoma in the isthmus

      Young Woo, Chang1; Hye Yoon, Lee1; Hwan Soo, Kim1; Gil Soo, Son1 1 Department of Surgery, Korea University College of Medicine, Seoul, Republic of Korea   Background: The incidence of papillary thyroid carcinoma (PTC) arising from the isthmus is low; however, these tumors have aggressive clinical and pathological features. Moreover, the existing guidelines regarding the extent of surgery for this type of tumor are unclear. Material & Methods: This study enrolled 282 patients who underwent total thyroidectomy with bilateral central lymph node dissection. The patients were divided into 2 groups based on the location of the median line of the PTC. Group I included patients in whom the median line was located between the lateral margins of the trachea; Group II included all others. We compared the 2 groups and conducted a multivariate analysis to assess risk factors for contralateral node metastasis from a PTC arising from the isthmus. Results:  Patients in Group I had significantly higher frequencies of extrathyroidal extension and central lymph node metastasis. Group I also had a higher frequency of contralateral node metastasis, and a tumor size >1.0 cm was identified as an independent risk factor for contralateral node metastasis among patients in this group. Conclusion: Bilateral central lymph node dissection should be considered for patients with PTCs >1.0 cm in size that have arisen from the isthmus.   References: 
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