464 patients with differentiated thyroid carcinoma were scored and treated using a risk-oriented management scheme employing early surgical re-intervention including compartment-oriented lymph-node dissection in cases of lymph-node metastases or local recurrences without routine external radiotherapy. A multivariate analysis showed that there was no effect of lymph-node metastases on survival. The difference in survival between patients with (24%) and without (76%) lymph-node metastases (univariate analysis) were due to the coincidence of higher tumor stage (T4) and higher incidence of peripheral metastases (M1). Thus, provided surgery is efficient, N1 is not a risk factor influencing survival.