The role of lymphadenectomy in the management of papillary carcinoma of the thyroid.

Impact of nodal involvement in papillary thyroid cancer remains controversial. The incidence of nodal metastases is high and the presence of involved nodes has a negative impact on recurrence and possibly on survival as well, particularly in older patients. The risk of nodal disease increases with age, tumor size, and BRAF oncogene expression. Most thyroid surgeons sample the ipsilateral central nodes as a minimum and clear the central compartment if there is gross adenopathy present. Lateral compartment neck dissection is reserved for patients with known metastatic disease. This article attempts to review the literature on surgery of lymph nodes in papillary thyroid cancer.