Prophylactic central compartment neck dissection in differentiated thyroid carcinoma: About an Algerian series

  • Introduction:
    Cervical lymph node metastasis has been predicted for local recurrence in differentiated thyroid carcinoma. The central compartmental dissection (PCND) includes removal of central compartment lymph nodes in the absence of clinical intervention on preoperative and intraoperative evaluation.

    Material and method:
    We report a retrospective study of 60 cases operated for suspicious thyroid nodules between January 2017 and December 2018; total thyroidectomy with PCND was performed systematically.

    Results:
    A female predominance (67%) was found, the average age was 57 years, a family history of thyroid carcinoma was present in 10% of cases, 84% was histologically differentiated thyroid carcinoma. PCND was positive in 34% of cases, changing the indication of radioactive iodine in 21.42% of patients. Nearly 10% of cases have been classified PT3 according to the TNM classification and at high risk according to the ATA2015, 29% were variants with bad prognosis.  28% of cases presented a complication of surgery (60% hypocalcemia, 40% recurrent laryngeal nerve injury).

    Discussion:
    The American Thyroid Association stated that PCND should be considered in patients who have advanced or clinically involved lateral neck nodes, while in Guidelines of the Japan Thyroid Association, PCND is accepted as a surgical strategy. In Africa, unfortunately, there are no guidelines for the specificity of our populations.

    Conclusion:
    Our population, has a high rate of central lymph node metastasis even in clinically node-negative patients.

 

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