Selective neck dissection in clinical node positive low risk papillary thyroid cancer patients

OBJECTIVE: To explore the improvement of modified radical neck dissection in clinical node positive (cN(+)) low risk papillary thyroid cancer patients. METHODS: Seventy-one cases of papillary thyroid cancer with cN(+) underwent selective neck dissection (IIa, III, IV) from 2007 to 2010 were reviewed, including 10 men and 61 women. All patients were at stage I, including 15 T1, 46 T2, 10 T3. Twenty-six patients were found Positive nodes were found by palpation in 26 cases and by ultrasonagraphy in 45 cases. RESULTS: Cervical lymph node metastasis were confirmed pathologically in 63 cases, with metastatic rate of 88.7%; 100% in cN(+) cases by palpation and 82.2% in cN(+) cases by ultrasonagraphy, respectively. Metastatic nodes existed in one level in 13 cases, two levels in 31 cases, and three levels in 19 cases. Recurrence occurred to 4 patients during follow up, with a recurrent rate of 5.6%, and 2 cases of them were found recurrence in the anterior part of Vb, 2 cases in the carotid sheath. CONCLUSION: Selective neck dissection (IIa, III, IV) is acceptable for cN(+) low risk papillary thyroid cancer patients, which can decrease complications in neck and shoulder greatly.