Whoa Now: Only Cut the Cancer

Thyroid cancer surgery may not benefit from removal of non cancerous lymph nodes

(RxWiki News) Better safe than sorry is a great motto, but it may not apply to removal of extra, non-cancerous lymph nodes in thyroid cancer surgery. Research suggests leaving the healthy ones intact.

A recent study looked at recurrences of papillary thyroid cancer after surgery. Tumor size and number of cancerous lymph nodes can influence odds of recurrence.

These researchers concluded that the chances of thyroid cancer coming back did not have anything to do with the number of lymph nodes removed in the first place.

"Talk to your doctor about the best treatment options."

Steven E. Rodgers, MD, PhD, from the Division of Endocrine Surgery at the Leonard M. Miller School of Medicine at the University of Miami in Florida, led the investigation.

For the study, researchers reviewed 117 patients who had radical neck surgery for papillary thyroid cancer.

Dr. Rodgers’ team looked for recurrence of thyroid cancer after surgery and any influential factors like radiation therapy, complications and how the surgery was performed.

Only 8 percent of the patients experienced a recurrence of the thyroid cancer. The number of lymph nodes removed during the initial surgery did not appear to influence the chance of thyroid cancer coming back.

The two factors that helped predict the return of thyroid cancer in the 8 percent were the number of cancer positive lymph nodes at the time of initial surgery and the size of the tumors.

An increased number of positive lymph nodes raised the odds of thyroid cancer recurrence by 1.16 times and larger tumor size increased odds of recurrence by 1.60 times. These results were independent of one another, not a combined risk factor.

“This study suggests that attempts to maximize the number of lymph nodes removed during modified radical neck dissection for papillary thyroid cancer may not be necessary.”

Further studies should be done on larger groups to verify results.

This study was published in October in Surgery.

No financial information was given and no conflicts of interest were reported.

Review Date: 
October 19, 2012