Is a bilateral modified radical neck dissection beneficial for patients with papillary thyroid cancer?

Abstract

Purpose: We previously reported a poor prognosis in papillary thyroid carcinoma patients with recurrence in the contralateral cervical lymph nodes after thyroidectomy and ipsilateral modified radical neck dissection (MRND) with a curative intent. The aim of this study was to investigate whether bilateral MRND improved prognosis in patients at risk for contralateral nodal recurrence.

Methods: We retrospectively reviewed the cases of 86 patients with contralateral nodal metastasis who underwent a thyroidectomy with bilateral MRND (group 1) and the cases of 32 patients who suffered contralateral nodal recurrence after a thyroidectomy with ipsilateral MRND (group 2).

Results: Although tumor progression was considered similar in patients from groups 1 and 2, group 1 developed fewer distant metastases than group 2 (6.8% vs 31.1%), thus resulting in a lower cancer death rate (5.8% vs 28.1%). Group 1 had a better 10-year survival rate than of group 2 (97.1% vs 83.7%).

Conclusion: Bilateral MRND during initial surgical management is thus considered to improve the prognosis of some papillary carcinoma patients at risk for recurrence in the contralateral cervical lymph nodes.