Navigation Links
Removal of lymph nodes during surgery for thyroid cancer may be beneficial

Papillary thyroid cancer accounts for the majority of all thyroid malignancies, which primarily impact women. A new study indicates that routinely removing lymph nodes in the neck in these cancer patients may help prevent the disease from coming back.

When thyroid cancer metastasizes, lymph nodes in the neck may be affected, but these lymph-node tumors can be tiny and may not be detected by ultrasounds done before surgery to remove the diseased thyroid or even during the procedure itself.

In an international academic study published in the December issue of the journal Surgery, UCLA researchers and colleagues demonstrate that routine removal of neck lymph nodes during initial thyroid surgery for papillary cancer may lead to lower disease recurrence rates and lower levels of thyroglobulin, a thyroid tumor marker that can be an indicator of disease when elevated.

Although it is standard procedure in some cancer centers, there has been debate in the worldwide surgical community about the benefits of routinely removing neck lymph nodes, a procedure known as prophylactic central neck lymph-node dissection, or CLND.

"We found that re-operation rates due to cancer were lower in patients who had routine removal of these lymph nodes, which suggests a more thorough surgical clearance of disease," said the study's senior author, Dr. Michael Yeh, an associate professor of surgery at the David Geffen School of Medicine at UCLA. "Our findings may help add to growing evidence that this additional procedure, performed during initial thyroid surgery, may be helpful in management of papillary thyroid cancer."

For the study, researchers examined data on 606 patients who received care in one of three endocrine surgical units in the U.S., England and Australia. Patients were divided into two groups: Group A patients had undergone total thyroid removal alone; Group B patients had undergone both thyroid removal and dissection of central neck lymph nodes. Patients were followed for an average of three-and-a-half years following surgery.

The standard pre-operative evaluation of all patients included a fine-needle biopsy of the primary thyroid tumor and determination of neck lymph-node disease status through physical examination and ultrasound of the neck.

The rate of disease recurrence in the entire study population was 6.9 percent. The researchers found that the need for central neck re-operation was significantly lower among patients who had undergone the routine initial central neck lymph-node dissection, compared with those who had undergone only thyroid removal (1.5 percent vs. 6.1 percent).

Stimulated thyroglobulin levels were also lower among patients in Group B, which may demonstrate a more thorough clearing of disease in the patients who had both thyroid and neck lymph-node removal procedures, the researchers said.

"This significant reduction in the need for further surgery in the critical central area of the neck is important, since it reduces risk to the many vital structures housed here, such as the nerves supplying the voice," said study co-author Dr. Mark Sywak of the University of Sydney in Australia.

UCLA's Yeh noted that blood thyroglobulin levels are a useful and sensitive measure in tracking disease recurrence, especially when many tumors in this area are too tiny to be detected using a physical exam or ultrasound.

Rates of temporarily low calcium levels, a common side effect, were significantly higher in Group B patients (9.7 percent), who had neck lymph nodes removed, than in Group A patients (4.1 percent) who had thyroid-removal surgery alone. The rate of long-term complications was low for both groups about 1 percent.

The researchers said the next step may be to conduct a prospective, randomized clinical trial to further assess the impact of routinely removing central neck lymph nodes during initial surgery for papillary thyroid cancer.


Contact: Rachel Champeau
University of California - Los Angeles Health Sciences

Related medicine news :

1. Early Ovary Removal May Raise Arthritis, Osteoporosis Risk
2. Lasers Safe for Removal of Pacemaker Wires in Elderly: Study
3. Surgical removal of the tonsils and appendix associated with risk of early heart attack
4. Tonsil Removal Might Cure Bedwetting in Some Kids With Sleep Apnea
5. Limited lymph node removal for certain breast cancer does not appear to result in poorer survival
6. Enzyme inhibition or removal may prevent or treat ischemic retinopathy
7. NOSCAR announces first NOTES transoral and transvaginal gallbladder removals performed as part of US multicenter human trial
8. Free InkBGone Stain Removal Products Being Offered By
9. Lice Control™ Incorporates the Revolutionary LouseBuster™ Device in its Head Lice Removal Arsenal in Northern California
10. Tattoo Removal Laser Clinic Announces New PhotoAcoustic Laser Technology
11. Kidney Removal May Be Ill-Advised for Some Elderly
Post Your Comments:
(Date:11/29/2015)... ... November 29, 2015 , ... ProStatic Analog Distortion ... tool designed specially for Final Cut Pro X. FCPX users can ... easy-to-use modification controls. Destoying and creating chaotic distortion is now quick and simple, ...
(Date:11/28/2015)... ... November 28, 2015 , ... Trying to relax on a couch can actually ... conceived of this design due to personal experience with a bad back," he said. ... and convenience, as well as increases support. It also makes it easier to eat, ...
(Date:11/27/2015)... Angeles, CA (PRWEB) , ... November 27, 2015 , ... ... study carried out by the University of Toronto and the University of British Columbia ... of hospitalizations for head injuries. The article explains that part of the reason for ...
(Date:11/27/2015)... ... November 27, 2015 , ... "When I ... an inventor from Hillside, N.J. "Many people catch diseases simply from sitting on ... will always be protected from germs." , He developed the patent-pending QUDRATECS to ...
(Date:11/27/2015)... ... November 27, 2015 , ... ... progress through sharing, the 2016 Building Better Radiology Marketing Programs meeting ... begin on Sunday, March 6, 2016, at Caesars Palace in Las Vegas with ...
Breaking Medicine News(10 mins):
(Date:11/26/2015)... , November 26, 2015 /PRNewswire/ ... announced the addition of the  "2016 ... the European Therapeutic Drug Monitoring (TDM) ... Competitive Intelligence, Emerging Opportunities"  report to ... ) has announced the addition of ...
(Date:11/26/2015)... ) has ... Market by Type (Reagents & Kits, Analyzers), ... Diagnostic Labs), Application (Research, Clinical Diagnostics), and ... report to their offering. --> ... the "Radioimmunoassay Market by Type (Reagents ...
(Date:11/25/2015)... 25, 2015  Amgen (NASDAQ: AMGN ) today ... with the United States (U.S.) ... biosimilar candidate to Humira ® (adalimumab). Amgen believes ... to the FDA and represents Amgen,s first BLA submission ... Harper , M.D., executive vice president of Research and ...
Breaking Medicine Technology: