Changing the operative strategy for thyroid cancer by node sampling.

One hundred fifty patients underwent thyroid surgery from 1979 to 1981, of whom 48 showed cancer for a 32 percent rate. In eight patients (16 percent), obvious clinical nodal disease was treated with modified neck dissection. Of the remaining 40 patients, internal jugular node sampling was carried out in 33, and revealed microscopic metastatic cancer in 12 patients who then underwent appropriate neck dissection. Node sampling increased our yield of nodal metastases from 16 to 42 percent, permitted one-hospitalization treatment, and afforded our patients the possibility of complete cancer control and prevention of the emergence of future recurrent disease. It is recommended that node sampling be incorporated into the operative strategy for thyroid cancer to permit intelligent selection of patients for modified neck dissection.