Central Lymph Node Dissection for Well-Differentiated Cancer

  • Allan SipersteinEmail author


The goal of any operation for well-differentiated thyroid cancer is to provide the best oncologic outcome, individualized to the patient, but avoid the morbidity of excessively radical procedures. Clinically involved central neck lymph nodes require removal. A major area of controversy is whether prophylactic central neck dissection is required for thyroid cancer of follicular cell origin. The exact definition of a prophylactic versus a therapeutic neck dissection varies. When neck dissection is performed, there is varied practice in terms of how thoroughly the central compartment is cleared of its nodal burden. There is also controversy as to whether a unilateral versus a bilateral central neck dissection should be performed. How to interpret or act on the final pathologic findings is also an area of controversy. Although any nodal involvement is staged as N1 disease, biologically the findings of microscopic nodal involvement are clearly different than that of nodal replacement or extranodal extension. In terms of gaining a better perspective into any of these areas, it is important to understand that with well-differentiated thyroid cancer, although this may impact the recurrence rate in the neck, given the excellent long-term survival, mortality is unlikely to be affected.


Central neck dissection Thyroid cancer Prophylactic neck dissection 


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Copyright information

© Springer International Publishing Switzerland 2016

Authors and Affiliations

  1. 1.Endocrine Surgery DepartmentCleveland ClinicClevelandUSA

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