Risk of Contralateral Central Compartment Recurrence Following Unilateral Therapeutic Neck Dissection for Papillary Thyroid Carcinoma

BACKGROUND AND OBJECTIVES: The utility of bilateral central compartment neck dissection (CCND) in patients with papillary thyroid carcinoma (PTC) and unilateral clinically node-positive disease remains debatable. Previous studies evaluated contralateral occult lymph-node metastases, which do not necessarily correlate with clinical recurrences. The objective of our study was to evaluate whether unilateral CCND is sufficient, specifically evaluating recurrence in the contralateral central neck. METHODS: Patients with PTC treated with total thyroidectomy and therapeutic unilateral CCND with at least 2 years of follow-up were included. RESULTS: A total of 118 patients had unilateral therapeutic CCND, 58% with lateral neck dissection, 63% female, mean age of 48.1 ± 16.3 years. Mean follow-up was 6.2 ± 3.9 years, tumor size 17.6 ± 12 mm, 39% had minimal extrathyroidal extension (ETE) and 4% had gross ETE. A mean of 2.6 ± 2.6 LN were involved in the central compartment (size 9.4 ± 6.5 mm) and 4.4 ± 4 involved in the lateral neck (size 24.9 ± 14.3 mm). Recurrence on the ipsilateral side was detected in 6 patients (5%), while contralateral central compartment recurrence (the primary outcome) was detected in only 1 patient (1%). CONCLUSIONS: In patients with PTC and unilateral clinically node-positive central compartment disease, unilateral therapeutic CCND is sufficient, with only 1% risk of recurrence in the contralateral central compartment.