Panagiotis Asimakopoulos1, Ashok R Shaha2, Iain J Nixon3, Jatin P Shah2, Gregory W Randolph4, Peter Angelos5, Mark E Zafereo6, Luiz P Kowalski7,8, Dana M Hartl9,10, Kerry D Olsen11, Juan P Rodrigo12,13,14, Vincent Vander Poorten15,16, Antti A Mäkitie17, Alvaro Sanabria18,19, Carlos Suárez20, Miquel Quer21,22, Francisco J Civantos23, K Thomas Robbins24, Orlando Guntinas-Lichius25, Marc Hamoir26, Alessandra Rinaldo27, Alfio Ferlito28. 1. Head and Neck Service, Memorial Sloan-Kettering Cancer Center, New York, NY, USA. asimakopoulos@doctors.org.uk. 2. Head and Neck Service, Memorial Sloan-Kettering Cancer Center, New York, NY, USA. 3. Department of Otorhinolaryngology Head and Neck Surgery, Edinburgh Royal Infirmary, Edinburgh, UK. 4. Division of Thyroid and Parathyroid Endocrine Surgery, Department of Otolaryngology, Massachusetts Eye and Ear Infirmary, Boston, MA, USA. 5. Department of Surgery and MacLean Center for Clinical Medical Ethics, The University of Chicago, Chicago, IL, USA. 6. Head and Neck Endocrine Surgery, The University of Texas MD Anderson Cancer Center, Houston, TX, USA. 7. Department of Otorhinolaryngology-Head and Neck Surgery, A.C. Camargo Cancer Center, São Paulo, Brazil. 8. Department of Head and Neck Surgery, University of São Paulo Medical School, São Paulo, Brazil. 9. Department of Otolaryngology-Head and Neck Surgery, Institut Gustave Roussy, Villejuif Cedex, France. 10. Laboratoire de Phonétique et de Phonologie, Paris, France. 11. Department of Otorhinolaryngology, Mayo Clinic, Rochester, MN, USA. 12. Department of Otolaryngology, Hospital Universitario Central de Asturias-ISPA, Oviedo, Spain. 13. University of Oviedo-IUOPA, Oviedo, Spain. 14. Head and Neck Cancer Unit, CIBERONC, Madrid, Spain. 15. Department of Otorhinolaryngology Head and Neck Surgery, University Hospitals Leuven, Leuven, Belgium. 16. Department of Oncology, Section Head and Neck Oncology, Leuven, Belgium. 17. Department of Otorhinolaryngology-Head and Neck Surgery, University of Helsinki and Helsinki University Hospital, Helsinki, Finland. 18. Department of Surgery, School of Medicine, Universidad de Antioquia/Hospital Universitario San Vicente Fundación, Medellín, Colombia. 19. CEXCA Centro de Excelencia en Enfermedades de Cabeza y Cuello, Medellín, Colombia. 20. Instituto de Investigación Sanitaria del Principado de Asturias and CIBERONC, ISCIII, University of Oviedo, Oviedo, Spain. 21. Department of Otolaryngology-Head and Neck Surgery, University Hospital de la Santa Creu i Sant Pau, Barcelona, Spain. 22. Surgery Department, Universitat Autonòma de Barcelona, Barcelona, Spain. 23. Department of Otolaryngology-Head and Neck Surgery, Sylvester Comprehensive Cancer Center, University of Miami Miller School of Medicine, Miami, FL, USA. 24. Department of Otolaryngology Head and Neck Surgery, Southern Illinois University Medical School, Springfield, IL, USA. 25. ENT Department, Jena University Hospital, Jena, Germany. 26. Department of Head and Neck Surgery, UC Louvain, St Luc University Hospital and King Albert II Cancer Institute, Brussels, Belgium. 27. University of Udine School of Medicine, Udine, Italy. 28. International Head and Neck Scientific Group, Padua, Italy.
Abstract
PURPOSE OF REVIEW: In this narrative review, we discuss the indications for elective and therapeutic neck dissections and the postoperative surveillance and treatment options for recurrent nodal disease in patients with well-differentiated thyroid cancer. RECENT FINDINGS: Increased availability of advanced imaging modalities has led to an increased detection rate of previously occult nodal disease in thyroid cancer. Nodal metastases are more common in young patients, large primary tumors, specific genotypes, and certain histological types. While clinically evident nodal disease in the lateral neck compartments has a significant oncological impact, particularly in the older age group, microscopic metastases to the central or the lateral neck in well-differentiated thyroid cancer do not significantly affect outcome. As patients with clinically evident nodal disease are associated with worse outcomes, they should be treated surgically in order to reduce rates of regional recurrence and improve survival. The benefit of elective neck dissection remains unverified as the impact of microscopic disease on outcomes is not significant.
PURPOSE OF REVIEW: In this narrative review, we discuss the indications for elective and therapeutic neck dissections and the postoperative surveillance and treatment options for recurrent nodal disease in patients with well-differentiated thyroid cancer. RECENT FINDINGS: Increased availability of advanced imaging modalities has led to an increased detection rate of previously occult nodal disease in thyroid cancer. Nodal metastases are more common in young patients, large primary tumors, specific genotypes, and certain histological types. While clinically evident nodal disease in the lateral neck compartments has a significant oncological impact, particularly in the older age group, microscopic metastases to the central or the lateral neck in well-differentiated thyroid cancer do not significantly affect outcome. As patients with clinically evident nodal disease are associated with worse outcomes, they should be treated surgically in order to reduce rates of regional recurrence and improve survival. The benefit of elective neck dissection remains unverified as the impact of microscopic disease on outcomes is not significant.
Authors: Mohamed Abdelgadir Adam; John Pura; Paolo Goffredo; Michaela A Dinan; Shelby D Reed; Randall P Scheri; Terry Hyslop; Sanziana A Roman; Julie A Sosa Journal: J Clin Oncol Date: 2015-06-15 Impact factor: 44.544
Authors: Dan-gui Yan; Bin Zhang; Chang-ming An; Zong-min Zhang; Zheng-jiang Li; Zhen-gang Xu; Ping-zhang Tang Journal: Zhonghua Er Bi Yan Hou Tou Jing Wai Ke Za Zhi Date: 2011-11