Abstract
Lymph node metastases are common with some types of thyroid cancer, and less common with others. Papillary thyroid cancer quite commonly includes spread to the lymph nodes at presentation, which can be managed by operative resection, radioiodine therapy, or a combination of both. The management strategy for potential nodal disease depends first upon the identification of the disease when present. The preoperative documentation of nodal disease allows the patient and the surgeon to plan appropriate intervention. If the staging ultrasound does not show node metastases, then there should be an active evaluation of the central (level 6) lymph nodes during operation for evidence of metastasis.
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References
Cooper DS, et al. Revised American Thyroid Association management guidelines for patients with thyroid nodules and differentiated thyroid cancer. Thyroid. 2009;19(11):1167–214.
Smallridge RC, et al. American Thyroid Association guidelines for management of patients with anaplastic thyroid cancer. Thyroid. 2012;22(11):1104–39.
Kouvaraki MA, et al. Role of preoperative ultrasonography in the surgical management of patients with thyroid cancer. Surgery. 2003;134(6):946–54; discussion 954–5.
Barczynski M, et al. Prophylactic central neck dissection for papillary thyroid cancer. Br J Surg. 2013;100(3):410–8.
Popadich A, et al. A multicenter cohort study of total thyroidectomy and routine central lymph node dissection for cN0 papillary thyroid cancer. Surgery. 2011;150(6):1048–57.
Hartl DM, et al. Influence of prophylactic neck dissection on rate of retreatment for papillary thyroid carcinoma. World J Surg. 2013;37(8):1951–8.
Sywak M, et al. Routine ipsilateral level VI lymphadenectomy reduces postoperative thyroglobulin levels in papillary thyroid cancer. Surgery. 2006;140(6):1000–5; discussion 1005–7.
Bonnet S, et al. Prophylactic lymph node dissection for papillary thyroid cancer less than 2 cm: implications for radioiodine treatment. J Clin Endocrinol Metab. 2009;94(4):1162–7.
Hartl DM, et al. Optimization of staging of the neck with prophylactic central and lateral neck dissection for papillary thyroid carcinoma. Ann Surg. 2012;255(4):777–83.
Laird AM, et al. Evaluation of postoperative radioactive iodine scans in patients who underwent prophylactic central lymph node dissection. World J Surg. 2012;36(6):1268–73.
Wang TS, et al. Effect of prophylactic central compartment neck dissection on serum thyroglobulin and recommendations for adjuvant radioactive iodine in patients with differentiated thyroid cancer. Ann Surg Oncol. 2012;19(13):4217–22.
Costa S, et al. Role of prophylactic central neck dissection in cN0 papillary thyroid cancer. Acta Otorhinolaryngol Ital. 2009;29(2):61–9.
Ryu IS, et al. Lymph node ratio of the central compartment is a significant predictor for locoregional recurrence after prophylactic central neck dissection in patients with thyroid papillary carcinoma. Ann Surg Oncol. 2014;21(1):277–83.
Chisholm EJ, Kulinskaya E, Tolley NS. Systematic review and meta-analysis of the adverse effects of thyroidectomy combined with central neck dissection as compared with thyroidectomy alone. Laryngoscope. 2009;119(6):1135–9.
Hughes DT, et al. Influence of prophylactic central lymph node dissection on postoperative thyroglobulin levels and radioiodine treatment in papillary thyroid cancer. Surgery. 2010;148(6):1100–6; discussion 1006–7.
Lang BH, et al. Impact of routine unilateral central neck dissection on preablative and postablative stimulated thyroglobulin levels after total thyroidectomy in papillary thyroid carcinoma. Ann Surg Oncol. 2012;19(1):60–7.
Raffaelli M, et al. Prospective evaluation of total thyroidectomy versus ipsilateral versus bilateral central neck dissection in patients with clinically node-negative papillary thyroid carcinoma. Surgery. 2012;152(6):957–64.
Zetoune T, et al. Prophylactic central neck dissection and local recurrence in papillary thyroid cancer: a meta-analysis. Ann Surg Oncol. 2010;17(12):3287–93.
Sancho JJ, et al. Prophylactic central neck disection in papillary thyroid cancer: a consensus report of the European Society of Endocrine Surgeons (ESES). Langenbecks Arch Surg. 2014;399(2):155–63.
Randolph GW, et al. The prognostic significance of nodal metastases from papillary thyroid carcinoma can be stratified based on the size and number of metastatic lymph nodes, as well as the presence of extranodal extension. Thyroid. 2012;22(11):1144–52.
Moreno MA, et al. In papillary thyroid cancer, preoperative central neck ultrasound detects only macroscopic surgical disease, but negative findings predict excellent long-term regional control and survival. Thyroid. 2012;22(4):347–55.
Gyorki DE, et al. Prophylactic central neck dissection in differentiated thyroid cancer: an assessment of the evidence. Ann Surg Oncol. 2013;20(7):2285–9.
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Doherty, G.M. (2016). Surgical Management of Lymph Node Metastases. In: Wartofsky, L., Van Nostrand, D. (eds) Thyroid Cancer. Springer, New York, NY. https://doi.org/10.1007/978-1-4939-3314-3_49
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DOI: https://doi.org/10.1007/978-1-4939-3314-3_49
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