American Thyroid Association Consensus Review and Statement Regarding the Anatomy, Terminology, and Rationale for Lateral Neck Dissection in Differentiated Thyroid Cancer

Stack, Brendan C.; Ferris, Robert L.; Goldenberg, David; Haymart, Megan R.; Shaha, Ashok R.; Sheth, Sheila; Sosa, Julie Ann; Tufano, Ralph P.

doi:10.1089/thy.2011.0312

Cited by 239 publications

(177 citation statements)

References 62 publications

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“…Cervical LNM in PTC have been identified as an independent risk factor for regional recurrence 4, 5, 6, 7, and emerging evidences from large population‐based studies have indicated decreased disease‐free survival rate and increased mortality associated with regional LNM 7, 8, 9, 10. There is universal agreement that therapeutic lateral neck dissection (LND) should be undertaken in patients with PTC and clinically lateral LNM (LLNM) on the basis of palpation or imaging examination 11, 12. However, determining the appropriate extent of LND remains controversial.…”

Section: Introductionmentioning

confidence: 99%

Risk factors for level V lymph node metastases in solitary papillary thyroid carcinoma with clinically lateral lymph node metastases

et al. 2016

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The extent of lateral neck dissection (LND) in surgical resection of papillary thyroid carcinoma (PTC) with clinically lateral LNM (LLNM) remains controversial. We aimed to explore the frequency of and risk factors for level V LNM in patients with solitary PTC and clinically LLNM. To analyze the frequency and risk factors for level V LNM, we retrospectively reviewed 220 solitary PTC patients who underwent total thyroidectomy, bilateral central neck dissection, and therapeutic LND. LLNM were present in 82.3% patients, and levels II–V LNM were present in 45.9%, 62.7%, 55.5%, and 12.3% patients, respectively. Ipsilateral level V LNM was significantly associated with tumor size >10 mm, extrathyroidal extension, ipsilateral central LNM ratio ≥50%, and contralateral central LNM (CLNM), bilateral CLNM, and simultaneous levels II–IV LNM. Contralateral CLNM was an independent risk factor for level V LNM. In patients with solitary PTC and clinically LLNM, level V LNM was relatively uncommon. Therefore, routine level V lymphadenectomy may be unnecessary in these patients unless level V LNM is suspected on preoperative examination or associated risk factors, especially contralateral CLNM, are present.

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Section: Introductionmentioning

confidence: 99%

Risk factors for level V lymph node metastases in solitary papillary thyroid carcinoma with clinically lateral lymph node metastases

et al. 2016

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“…47 In terms of the surgical approach to regional nodes, a compartment-orientated neck dissection is recommended for all patients with metastatic disease. 48 If this involves the central neck, bilateral levels VI and VII should be dissected. If the lateral neck is also involved, dissection of levels IIa, III, IV, and V is recommended in a "comprehensive neck dissection.…”

Section: Approach To Therapymentioning

confidence: 99%

Our Understanding of Well-differentiated Thyroid Cancer

Thompson¹,

Nixon²,

Souza³

2017

International Journal of Head and Neck Surgery

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Through significant contributions to our understanding of risk factors, prognostic indicators and management of welldifferentiated thyroid cancer (WDTC), Prof Jatin Shah has contributed much to the field of thyroid cancer in recent times. Many of the guidelines used in WDTC management today are a testament to his less-aggressive, dedicated and individualised approach. This article seeks to both review the current understanding of WDTC and to outline these contributions in a special issue dedicated to the career of Prof Shah.

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“…1). 59) In the absence of significant lymphadenopathy at levels IIa, III, IV and Vb, disease above the spinal accessory nerve (IIb or Va) or in level I is uncommon.…”

Section: Lateral Neck Dissectionmentioning

confidence: 99%

“…Therefore, the ATA recommended a comprehensive selective neck dissection of levels IIa, III, IV, and Vb. 59) In comparison with the central compartment, the lateral neck harbors lower rates (23%) 60) of occult metastasis and elective surgery results in higher postoperative complication rates. Despite this, some experts continue to advocate selective prophylactic lateral neck dissection.…”

Section: Lateral Neck Dissectionmentioning

confidence: 99%

Regional Lymph Node Metastasis in Papillary Thyroid Cancer

Park

Lee

Bae

et al. 2014

J Korean Thyroid Assoc

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Papillary thyroid cancer is a common endocrine cancer and commonly presents with lymph node metastases. It has been generally accepted that lymphatic drainage occurs from the thyroid primarily to the central lymphatic compartment and secondarily to the lateral compartment nodes. Recently, improvements in the resolution of imaging studies and the availability of highly sensitive thyroglobulin assays have highlighted the importance of identifying disease in the pre-operative assessment and dealing effectively with metastatic regional disease in order to prevent recurrence. However, there are limitations to diagnosing central lymph node metastases. With unreliable imaging modalities, prophylactic central lymph node dissection should be performed on all patients with papillary thyroid cancer. In comparison with the central compartment, prophylactic lateral node dissection has little or no effect on improving the prognosis of patients with papillary thyroid cancer. Therefore, lateral node dissection is recommended only as a part of the therapeutic procedure. The extension of lateral neck dissection is recommended a comprehensive selective neck dissection of levels IIa, III, IV, and Vb. The rich lymphatic supply of the thyroid gland coupled with the propensity for nodal metastases in papillary thyroid cancer require the modern thyroid surgeon to be familiar with the indications for and techniques of regional lymph node dissection.

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American Thyroid Association Consensus Review and Statement Regarding the Anatomy, Terminology, and Rationale for Lateral Neck Dissection in Differentiated Thyroid Cancer

Cited by 239 publications

References 62 publications

Risk factors for level V lymph node metastases in solitary papillary thyroid carcinoma with clinically lateral lymph node metastases

Risk factors for level V lymph node metastases in solitary papillary thyroid carcinoma with clinically lateral lymph node metastases

Our Understanding of Well-differentiated Thyroid Cancer

Regional Lymph Node Metastasis in Papillary Thyroid Cancer

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