Morbidity patterns and long-term outcomes of central lymph node dissection in thyroid cancer patients

Abstract Central lymph node metastasis (CLNM) is observed in 20-90% of patients with differentiated thyroid cancer (DTC). Central lymph node dissection (CLND) is associated with a higher incidence of complications, including hypocalcemia and an increased risk of recurrent laryngeal nerve injury. Thi...

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Main Authors: Khalid Atallah, Shadi Awny, Khaled Abdelwahab, Ahmed Abdallah, Islam H Metwally, Omar Hamdy, Mohammed Zuhdy, Ahmed Fareed
Format: Article
Language:English
Published: Nature Portfolio 2025-07-01
Series:Scientific Reports
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Online Access:https://doi.org/10.1038/s41598-025-08439-8
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author Khalid Atallah
Shadi Awny
Khaled Abdelwahab
Ahmed Abdallah
Islam H Metwally
Omar Hamdy
Mohammed Zuhdy
Ahmed Fareed
author_facet Khalid Atallah
Shadi Awny
Khaled Abdelwahab
Ahmed Abdallah
Islam H Metwally
Omar Hamdy
Mohammed Zuhdy
Ahmed Fareed
author_sort Khalid Atallah
collection DOAJ
description Abstract Central lymph node metastasis (CLNM) is observed in 20-90% of patients with differentiated thyroid cancer (DTC). Central lymph node dissection (CLND) is associated with a higher incidence of complications, including hypocalcemia and an increased risk of recurrent laryngeal nerve injury. This study aimed to characterize and analyze the morbidity of CLND precisely. This is a retrospective cohort study that included patients who were diagnosed with thyroid cancer and underwent total thyroidectomy and CLND at a tertiary cancer center from January 2012 to December 2023. Among 420 patients, intraoperative complications were observed in 47 patients (11.2%). The commonest was recurrent laryngeal nerve palsy, which occurred in 16 patients. Stridor was detected immediately after extubating five patients. The commonest postoperative complication was hypocalcemia, which occurred in 69 patients (16.4% of patients), 21 patients (5%) required hospital re-admission, and most of them were temporary (79.4%). CLND may lead to morbidity in 1 to 2 of every 10 patients. Better diagnostic tools and predictive models are mandatory to identify the central compartment disease burden. Moreover, more advanced surgical techniques are needed to spare the patients the potential complications.
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spelling doaj-art-1a484c635cf746b09ad1ca0d19cafd6e2025-08-20T03:45:28ZengNature PortfolioScientific Reports2045-23222025-07-011511810.1038/s41598-025-08439-8Morbidity patterns and long-term outcomes of central lymph node dissection in thyroid cancer patientsKhalid Atallah0Shadi Awny1Khaled Abdelwahab2Ahmed Abdallah3Islam H Metwally4Omar Hamdy5Mohammed Zuhdy6Ahmed Fareed7Surgical Oncology Department, Oncology Center, Faculty of Medicine, Mansoura UniversitySurgical Oncology Department, Oncology Center, Faculty of Medicine, Mansoura UniversitySurgical Oncology Department, Oncology Center, Faculty of Medicine, Mansoura UniversitySurgical Oncology Department, Oncology Center, Faculty of Medicine, Mansoura UniversitySurgical Oncology Department, Oncology Center, Faculty of Medicine, Mansoura UniversitySurgical Oncology Department, Oncology Center, Faculty of Medicine, Mansoura UniversitySurgical Oncology Department, Oncology Center, Faculty of Medicine, Mansoura UniversitySurgical Oncology Department, Oncology Center, Faculty of Medicine, Mansoura UniversityAbstract Central lymph node metastasis (CLNM) is observed in 20-90% of patients with differentiated thyroid cancer (DTC). Central lymph node dissection (CLND) is associated with a higher incidence of complications, including hypocalcemia and an increased risk of recurrent laryngeal nerve injury. This study aimed to characterize and analyze the morbidity of CLND precisely. This is a retrospective cohort study that included patients who were diagnosed with thyroid cancer and underwent total thyroidectomy and CLND at a tertiary cancer center from January 2012 to December 2023. Among 420 patients, intraoperative complications were observed in 47 patients (11.2%). The commonest was recurrent laryngeal nerve palsy, which occurred in 16 patients. Stridor was detected immediately after extubating five patients. The commonest postoperative complication was hypocalcemia, which occurred in 69 patients (16.4% of patients), 21 patients (5%) required hospital re-admission, and most of them were temporary (79.4%). CLND may lead to morbidity in 1 to 2 of every 10 patients. Better diagnostic tools and predictive models are mandatory to identify the central compartment disease burden. Moreover, more advanced surgical techniques are needed to spare the patients the potential complications.https://doi.org/10.1038/s41598-025-08439-8Papillary thyroid carcinomaMedullary thyroid carcinomaThyroid cancerCentral lymph node dissectionHypocalcemiaRecurrent laryngeal nerve injury
spellingShingle Khalid Atallah
Shadi Awny
Khaled Abdelwahab
Ahmed Abdallah
Islam H Metwally
Omar Hamdy
Mohammed Zuhdy
Ahmed Fareed
Morbidity patterns and long-term outcomes of central lymph node dissection in thyroid cancer patients
Scientific Reports
Papillary thyroid carcinoma
Medullary thyroid carcinoma
Thyroid cancer
Central lymph node dissection
Hypocalcemia
Recurrent laryngeal nerve injury
title Morbidity patterns and long-term outcomes of central lymph node dissection in thyroid cancer patients
title_full Morbidity patterns and long-term outcomes of central lymph node dissection in thyroid cancer patients
title_fullStr Morbidity patterns and long-term outcomes of central lymph node dissection in thyroid cancer patients
title_full_unstemmed Morbidity patterns and long-term outcomes of central lymph node dissection in thyroid cancer patients
title_short Morbidity patterns and long-term outcomes of central lymph node dissection in thyroid cancer patients
title_sort morbidity patterns and long term outcomes of central lymph node dissection in thyroid cancer patients
topic Papillary thyroid carcinoma
Medullary thyroid carcinoma
Thyroid cancer
Central lymph node dissection
Hypocalcemia
Recurrent laryngeal nerve injury
url https://doi.org/10.1038/s41598-025-08439-8
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