Prophylactic neck dissection for low-risk differentiated thyroid cancers: Risk-benefit analysis
Résumé
Background. The benefit of neck dissection is the subject of debate in differentiated thyroid cancer (DTC). We analyze the risk-benefit of neck dissection for low-risk DTC without detectable lymph nodes. Methods. We conducted a retrospective study from 1983 to 2003; which included 295 patients without detectable lymph nodes who were treated by thyroidectomy with (C1) or without (C-) neck dissection. All patients had iodine131 therapy. We compared the frequency of remission, disease progression, and permanent complications between groups. Results. Two hundred twelve patients comprised the C1 group, and 83 patients the C-group. Respectively for C1 versus C-, remission rates were 92% versus 89.2% (p 5 .40), and progressive disease observed was 3.3% versus 7.2% (p 5 .10). Permanent hypoparathyroidism occurred in 15.1% in C1 versus 3.6% in C-(p 5 .006). Conclusion. The risk-benefit analysis of neck dissection in patients with low-risk DTC shows no benefit in terms of complete remission or occurrence of progression. However, risk of complications seems to be higher in patients with neck dissection.
Domaines
Sciences du Vivant [q-bio]
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