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Revista Colombiana de Cirugía
versión impresa ISSN 2011-7582versión On-line ISSN 2619-6107
Resumen
AGAMEZ-FUENTES, José Eduardo y SANABRIA, Álvaro Enrique. Impact of the node-stage migration phenomenon on survival and recurrence of patients with papillary thyroid cancer who underwent prophylactic lymph node dissection. rev. colomb. cir. [online]. 2021, vol.36, n.4, pp.599-610. Epub 15-Feb-2022. ISSN 2011-7582. https://doi.org/10.30944/20117582.853.
Introduction.
The role of prophylactic central lymph node dissection at the time of total thyroidectomy remains controversial in clinically node-negative (cN0) papillary thyroid carcinoma. Moreover, a prospective randomized controlled trial of prophylactic central lymph node dissection in cN0 RCT is not readily feasible.
Methods.
In this study we simulated cN0 and clinically node-positive (cN+) populations, to evaluate impact of nodal stage migration in papillary thyroid carcinoma patients that undergo prophylactic central neck dissection. We use simulations of population and nodal stages.
Results.
Nodal stage migration phenomenon seems to have an improvement in locoregional recurrence and overall survival of cN0 and cN+ populations, without changes in overall population and individual outcomes.
Discussion.
Nodal stage migration is recognized as an important bias that precludes the use of historical controls groups in experimental treatment trials. In accordance to our findings, this phenomenon could explain the improvements observed in outcomes in patients that undergo prophylactic central neck dissection.
Palabras clave : papillary thyroid cancer; lymph node excision; nodal stage migration; central neck dissection; local neoplasm recurrence; survival.
