Abstract
Background
Medullary thyroid cancer is a neuroendocrine malignancy that can occur sporadically
or as the result of genomic rearranged during transfection mutations. Medullary thyroid
cancer has a higher rate of metastasis than well-differentiated thyroid cancer. Lateral
neck dissection is often performed, and its prophylactic use is controversial.
Methods
Single-center, retrospective review (2000–2017) of patients undergoing primary surgical
treatment for medullary thyroid cancer who had negative lateral neck imaging preoperatively.
Demographics, genetic associations, clinical, and imaging findings were analyzed.
Locoregional recurrence, overall recurrence, and overall survival were examined.
Results
A total of 110 patients were identified, of which 18 underwent prophylactic lateral
neck dissection and 92 did not. Age, sex distribution, preoperative calcitonin levels,
and follow-up were similar among groups. Overall recurrence was 20% for no prophylactic
lateral neck dissection and 39% for prophylactic lateral neck dissection (P = .46). Most recurrences were locoregional recurrence, 7.6% for no prophylactic lateral
neck dissection versus 22% for prophylactic lateral neck dissection (P = .08), half of it being to the lateral neck in both groups. A total of 7 patients
from the no prophylactic lateral neck dissection group required treatment for recurrences
versus 4 patients in prophylactic lateral neck dissection group (P = .57). Overall survival at 5 years was similar, 43% the no prophylactic lateral
neck dissection group and 31% for prophylactic lateral neck dissection group (P = .52).
Conclusion
Lateral neck dissection has no effect in decreasing locoregional or overall recurrences
in medullary thyroid cancer and has no effect in overall survival when performed prophylactically
at index surgical intervention.
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Article info
Publication history
Published online: July 18, 2021
Accepted:
April 15,
2021
Identification
Copyright
© 2021 Elsevier Inc. All rights reserved.
