Int J Thyroidol.  2020 Nov;13(2):79-84. 10.11106/ijt.2020.13.2.79.

Optimal Neck Dissection Extent for Metastatic Lymph Nodes in Papillary Thyroid Cancer

Affiliations
  • 1Department of Otorhinolaryngology-Head and Neck Surgery, College of Medicine, Pusan National University and Biomedical Research Institute, Pusan National University Hospital, Busan, Korea

Abstract

Papillary thyroid cancer (PTC) has a good prognosis, but the frequency of regional lymph node metastasis is reported to be up to 90%. In most patients with PTC, nodal metastasis occurs in a stepwise fashion, with metastasis beginning in the central cervical compartment, continuing to the ipsilateral cervical compartment. There are many controversies about the necessity of prophylactic central neck dissection (CND) and extent of therapeutic CND for lymph node metastasis. Ipsilateral CND with intraoperative frozen biopsy in PTC is a very sensitive and useful tool for the evaluation of nodal status in the central compartment. The right upper para-esophageal lymph nodes should be removed during dissection in patients with right paratracheal lymph node metastasis. Prophylactic lateral neck dissection (LND) is not recommended, and optimal extent of therapeutic LND is still controversial. Further studies on factors and clinical implications related to suprasternal lymph node metastasis are needed.

Keyword

Papillary thyroid cancer; Neck dissection; Lymph node; Metastasis
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