Prophylactic central lymph node dissection informs the decision of radioactive iodine ablation in papillary thyroid cancer

Carolina Nylén; Frida Bragvad Eriksson; Anna Yang; Ahmad Aniss; John Turchini; Diana Learoyd; Bruce G. Robinson; Anthony J. Gill; Roderick J. Clifton-Bligh; Mark S. Sywak; Anthony R. Glover; Stan B. Sidhu

doi:10.1016/j.amjsurg.2020.08.012

Prophylactic central lymph node dissection informs the decision of radioactive iodine ablation in papillary thyroid cancer

Carolina Nylén, Frida Bragvad Eriksson, Anna Yang, Ahmad Aniss, John Turchini, Diana Learoyd, Bruce G. Robinson, Anthony J. Gill, Roderick J. Clifton-Bligh, Mark S. Sywak, Anthony R. Glover, Stan B. Sidhu

Research output: Contribution to journal › Article › peer-review

22 Citations (Scopus)

Abstract

Background: Prophylactic central lymph node dissection (CLND) in papillary thyroid cancer (PTC) is controversial. We aimed to investigate if prophylactic CLND aids risk stratification and contributes to the decision for postoperative RAI ablation.

Methods: Patients undergoing thyroidectomy for PTC and prophylactic CLND were identified from an endocrine surgical unit database. Pathology reports where reviewed for number and size of lymph nodes and patients stratified by risk according to the ATA guidelines.

Results: 426 patients were identified with PTC ≤4 cm and prophylactic CLND. 96 patients (23%) had central lymph node metastasis (CLNM) that qualified them for the intermediate risk group. In 17 patients (4%), the CLNM data led to upgrading independently of other histopathological characteristics. Correcting for multiple variables, CLNM was an independent factor contributing to RAI treatment.

Conclusion: Prophylactic CLND provides information to aid the selection of RAI ablation independent of primary cancer histology for risk stratification in 4% of patients. This benefit should be carefully balanced with the risk of CLND and patient treatment choice when deciding on management of PTC ≤4 cm.

Original language	English
Pages (from-to)	886-892
Number of pages	7
Journal	The American Journal of Surgery
Volume	221
Issue number	5
DOIs	https://doi.org/10.1016/j.amjsurg.2020.08.012
Publication status	Published - May 2021

Keywords

Papillary thyroid cancer
Prophylactic central lymph node dissection
Radioactive iodine ablation
Risk assessment

Access to Document

10.1016/j.amjsurg.2020.08.012

Cite this

Nylén, C., Bragvad Eriksson, F., Yang, A., Aniss, A., Turchini, J., Learoyd, D., Robinson, B. G., Gill, A. J., Clifton-Bligh, R. J., Sywak, M. S., Glover, A. R., & Sidhu, S. B. (2021). Prophylactic central lymph node dissection informs the decision of radioactive iodine ablation in papillary thyroid cancer. The American Journal of Surgery, 221(5), 886-892. https://doi.org/10.1016/j.amjsurg.2020.08.012

@article{501fef4e5d254eb0a557194c49d5382c,

title = "Prophylactic central lymph node dissection informs the decision of radioactive iodine ablation in papillary thyroid cancer",

abstract = "Background: Prophylactic central lymph node dissection (CLND) in papillary thyroid cancer (PTC) is controversial. We aimed to investigate if prophylactic CLND aids risk stratification and contributes to the decision for postoperative RAI ablation. Methods: Patients undergoing thyroidectomy for PTC and prophylactic CLND were identified from an endocrine surgical unit database. Pathology reports where reviewed for number and size of lymph nodes and patients stratified by risk according to the ATA guidelines. Results: 426 patients were identified with PTC ≤4 cm and prophylactic CLND. 96 patients (23\%) had central lymph node metastasis (CLNM) that qualified them for the intermediate risk group. In 17 patients (4\%), the CLNM data led to upgrading independently of other histopathological characteristics. Correcting for multiple variables, CLNM was an independent factor contributing to RAI treatment. Conclusion: Prophylactic CLND provides information to aid the selection of RAI ablation independent of primary cancer histology for risk stratification in 4\% of patients. This benefit should be carefully balanced with the risk of CLND and patient treatment choice when deciding on management of PTC ≤4 cm.",

keywords = "Papillary thyroid cancer, Prophylactic central lymph node dissection, Radioactive iodine ablation, Risk assessment",

author = "Carolina Nyl{\'e}n and \{Bragvad Eriksson\}, Frida and Anna Yang and Ahmad Aniss and John Turchini and Diana Learoyd and Robinson, \{Bruce G.\} and Gill, \{Anthony J.\} and Clifton-Bligh, \{Roderick J.\} and Sywak, \{Mark S.\} and Glover, \{Anthony R.\} and Sidhu, \{Stan B.\}",

year = "2021",

month = may,

doi = "10.1016/j.amjsurg.2020.08.012",

language = "English",

volume = "221",

pages = "886--892",

journal = "The American Journal of Surgery",

issn = "0002-9610",

publisher = "Elsevier",

number = "5",

}

Nylén, C, Bragvad Eriksson, F, Yang, A, Aniss, A, Turchini, J, Learoyd, D, Robinson, BG, Gill, AJ, Clifton-Bligh, RJ, Sywak, MS, Glover, AR & Sidhu, SB 2021, 'Prophylactic central lymph node dissection informs the decision of radioactive iodine ablation in papillary thyroid cancer', The American Journal of Surgery, vol. 221, no. 5, pp. 886-892. https://doi.org/10.1016/j.amjsurg.2020.08.012

TY - JOUR

T1 - Prophylactic central lymph node dissection informs the decision of radioactive iodine ablation in papillary thyroid cancer

AU - Nylén, Carolina

AU - Bragvad Eriksson, Frida

AU - Yang, Anna

AU - Aniss, Ahmad

AU - Turchini, John

AU - Learoyd, Diana

AU - Robinson, Bruce G.

AU - Gill, Anthony J.

AU - Clifton-Bligh, Roderick J.

AU - Sywak, Mark S.

AU - Glover, Anthony R.

AU - Sidhu, Stan B.

PY - 2021/5

Y1 - 2021/5

N2 - Background: Prophylactic central lymph node dissection (CLND) in papillary thyroid cancer (PTC) is controversial. We aimed to investigate if prophylactic CLND aids risk stratification and contributes to the decision for postoperative RAI ablation. Methods: Patients undergoing thyroidectomy for PTC and prophylactic CLND were identified from an endocrine surgical unit database. Pathology reports where reviewed for number and size of lymph nodes and patients stratified by risk according to the ATA guidelines. Results: 426 patients were identified with PTC ≤4 cm and prophylactic CLND. 96 patients (23%) had central lymph node metastasis (CLNM) that qualified them for the intermediate risk group. In 17 patients (4%), the CLNM data led to upgrading independently of other histopathological characteristics. Correcting for multiple variables, CLNM was an independent factor contributing to RAI treatment. Conclusion: Prophylactic CLND provides information to aid the selection of RAI ablation independent of primary cancer histology for risk stratification in 4% of patients. This benefit should be carefully balanced with the risk of CLND and patient treatment choice when deciding on management of PTC ≤4 cm.

AB - Background: Prophylactic central lymph node dissection (CLND) in papillary thyroid cancer (PTC) is controversial. We aimed to investigate if prophylactic CLND aids risk stratification and contributes to the decision for postoperative RAI ablation. Methods: Patients undergoing thyroidectomy for PTC and prophylactic CLND were identified from an endocrine surgical unit database. Pathology reports where reviewed for number and size of lymph nodes and patients stratified by risk according to the ATA guidelines. Results: 426 patients were identified with PTC ≤4 cm and prophylactic CLND. 96 patients (23%) had central lymph node metastasis (CLNM) that qualified them for the intermediate risk group. In 17 patients (4%), the CLNM data led to upgrading independently of other histopathological characteristics. Correcting for multiple variables, CLNM was an independent factor contributing to RAI treatment. Conclusion: Prophylactic CLND provides information to aid the selection of RAI ablation independent of primary cancer histology for risk stratification in 4% of patients. This benefit should be carefully balanced with the risk of CLND and patient treatment choice when deciding on management of PTC ≤4 cm.

KW - Papillary thyroid cancer

KW - Prophylactic central lymph node dissection

KW - Radioactive iodine ablation

KW - Risk assessment

UR - https://www.scopus.com/pages/publications/85090003720

U2 - 10.1016/j.amjsurg.2020.08.012

DO - 10.1016/j.amjsurg.2020.08.012

M3 - Article

C2 - 32878695

SN - 0002-9610

VL - 221

SP - 886

EP - 892

JO - The American Journal of Surgery

JF - The American Journal of Surgery

IS - 5

ER -

Prophylactic central lymph node dissection informs the decision of radioactive iodine ablation in papillary thyroid cancer

Abstract

Keywords

Access to Document

Other files and links

Fingerprint

Cite this