A Nod to the Nodes: An Overview of the Role of Central Neck Dissection in the Management of Papillary Thyroid Carcinoma

Robert Mechera; Isabella Maréchal-Ross; Stan B Sidhu; Peter Campbell; Mark S Sywak

doi:10.1016/j.soc.2022.10.012

A Nod to the Nodes: An Overview of the Role of Central Neck Dissection in the Management of Papillary Thyroid Carcinoma

Surg Oncol Clin N Am. 2023 Apr;32(2):383-398. doi: 10.1016/j.soc.2022.10.012.

Authors

Robert Mechera¹, Isabella Maréchal-Ross², Stan B Sidhu³, Peter Campbell⁴, Mark S Sywak³

Affiliations

¹ Endocrine Surgery Unit, Royal North Shore Hospital, Northern Sydney Local Health District and Northern Clinical School, Sydney Medical School, Faculty of Medicine and Health, University of Sydney, St. Leonards, New South Wales 2065, Australia; Clarunis, University Hospital Basel, Spitalstrasse 21, Basel 4031, Switzerland; Endocrine and Breast Surgery, St. George Hospital, Gray Street, Kogarah, New South Wales 2217, Australia. Electronic address: [email protected].
² Endocrine Surgery Unit, Royal North Shore Hospital, Northern Sydney Local Health District and Northern Clinical School, Sydney Medical School, Faculty of Medicine and Health, University of Sydney, St. Leonards, New South Wales 2065, Australia.
³ Endocrine Surgery Unit, Royal North Shore Hospital, Northern Sydney Local Health District and Northern Clinical School, Sydney Medical School, Faculty of Medicine and Health, University of Sydney, St. Leonards, New South Wales 2065, Australia; Sydney Medical School, Faculty of Medicine and Health, University of Sydney, Sydney, New South Wales 2006, Australia.
⁴ Endocrine and Breast Surgery, St. George Hospital, Gray Street, Kogarah, New South Wales 2217, Australia.

PMID: 36925192
DOI: 10.1016/j.soc.2022.10.012

Abstract

Lymph node metastasis in thyroid cancer is common and associated with an increased risk of locoregional recurrence (LRR). Although therapeutic central neck dissection is well established, prophylactic central node dissection (pCND) for microscopic occult nodal involvement is controversial and recommendations are based on low-level evidence. The potential benefits of pCND such as reducing LRR and re-operation, refining staging, and improving surveillance are enthusiastically debated and the decision to perform pCND must be weighed up against the increased risks of complications.

Keywords: Central neck dissection; Metastasis; Micrometastasis; Papillary thyroid cancer; Prophylactic central neck dissection; Recurrence; Thyroid cancer.

Publication types

Review

MeSH terms

Carcinoma, Papillary* / surgery
Humans
Lymph Nodes / surgery
Neck Dissection
Neoplasm Recurrence, Local / pathology
Thyroid Cancer, Papillary / etiology
Thyroid Cancer, Papillary / pathology
Thyroid Cancer, Papillary / surgery
Thyroid Neoplasms* / surgery
Thyroidectomy / adverse effects