Background: The utility and safety of level VI central compartment lymph node dissection (LND) for the early detection of lymph node (LN) involvement during diagnostic hemithyroidectomy, for the evaluation of suspicious thyroid nodules, has yet to be established in the literature.
Methods: A retrospective review of all patients who underwent diagnostic hemithyroidectomy with level VI LND from a large head and neck oncology program from October 1, 2001, to May 10, 2009, was performed.
Results: A consecutive series of 78 patients were reviewed. Twenty-six patients (29.8%) were diagnosed with malignant neoplasm. All patients with malignant LNs (n = 5; 6.4%) were diagnosed with papillary carcinoma. On average, 4.8 LNs were found through neck dissection in patients with positive nodes compared to 2.4 LNs in those without lymph node involvement (p = .04). No postoperative adverse events in the patient group were attributed to the level VI neck dissection.
Conclusions: In patients undergoing diagnostic hemithyroidectomies, routine level VI LND was able to identify LN metastases in 6.4% of patients. The number of LNs was a strong predictor of positive node disease. Minimal surgical risks are associated with this procedure, and surgeons may avoid the risks of level VI reexploration in subsequent completion thyroidectomy.