Central lymph node dissection in patients with papillary thyroid cancer: a population level analysis of 14,257 cases

BackgroundThis study analyzes the impact of demographics and tumor size on the use of central compartment lymph node dissection (CLND) for papillary thyroid cancer (PTC) in the United States.MethodsAdult patients with PTC and the follicular variant of PTC who underwent thyroidectomy with or without CLND and were reported in the Surveillance Epidemiology and End Results (SEER) database from 2004 to 2008 were included. Bivariate and multivariate analyses were performed to determine the effects of demographic and clinical characteristics on the likelihood of a patient undergoing CLND.ResultsOf 14,257 patients included, 80.3% were women, 84.3% were white, average age was 50.1 years, and 37.1% had CLND. Over 5 years, there was an 18.3% increase in CLND, with the greatest increase seen in patients with T1 tumors (23.2%). Patients who were older, men, black, and from the South were less likely to undergo CLND; however, there were no differences in the total number of lymph nodes examined based on patient demographics or the year of their thyroid cancer diagnoses.ConclusionsBeing older, black, and from the South are negatively associated with CLND. This practice variation suggests potential disparity in access and quality of surgical care for PTC in the United States.