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The Debate for Elective Lymph Node Dissection in Papillary Thyroid Carcinoma

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Management of Differentiated Thyroid Cancer

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Abstract

The role of prophylactic central compartment lymph node dissection in papillary thyroid cancer remains a controversial issue. It is estimated that approximately 40% of patients with tumours >1 cm will have central node compartment metastases that are clinically undetectable. The performance of a routine or prophylactic central node dissection ensures that clinically undetectable nodal metastases are resected. Information about nodal status can be used to modify disease stage, alter risk stratification and influence the timing and dosing of radioactive iodine therapy. Furthermore, dissection of the central compartment lymph nodes reduces the risk of local recurrence and does so without an increased risk of permanent complications. Central node dissection is a safe procedure with multiple benefits to the patient and clinician and should be performed routinely in addition to thyroidectomy for patients with primary papillary thyroid carcinoma >1 cm.

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Abbreviations

AJCC:

American Joint Committee on Cancer

ATA:

American Thyroid Association

CND:

Central node dissection

PTC:

Papillary thyroid cancer

RAI:

Radioactive iodine

Tg:

Thyroglobulin

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Author information

Authors and Affiliations

  1. Department of Surgery, University of Washington, 1959 NE Pacific Street, Box #356410, Seattle, WA, 98195, USA

    Nicole Zern M.D.

  2. University of Sydney Endocrine Surgery Unit, Level 3 ASB, Royal North Shore Hospital, Reserve Road, St. Leonards, NSW, 2065, Australia

    Mark Sywak M.B.B.S., F.R.A.C.S., MMed Sci

Authors
  1. Nicole Zern M.D.
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  2. Mark Sywak M.B.B.S., F.R.A.C.S., MMed Sci
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Corresponding author

Correspondence to Nicole Zern M.D. .

Editor information

Editors and Affiliations

  1. General Surgery, Central Arkansas Veterans Healthcare System, University of Arkansas, Little Rock, Arkansas, USA

    Anne T. Mancino

  2. Division of Surgical Oncology, University of North Carolina, Chapel Hill, North Carolina, USA

    Lawrence T. Kim

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Zern, N., Sywak, M. (2017). The Debate for Elective Lymph Node Dissection in Papillary Thyroid Carcinoma. In: Mancino, A., Kim, L. (eds) Management of Differentiated Thyroid Cancer. Springer, Cham. https://doi.org/10.1007/978-3-319-54493-9_14

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  • DOI: https://doi.org/10.1007/978-3-319-54493-9_14

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  • Publisher Name: Springer, Cham

  • Print ISBN: 978-3-319-54492-2

  • Online ISBN: 978-3-319-54493-9

  • eBook Packages: MedicineMedicine (R0)

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