Skip to main content
SpringerLink
Log in

Neck Dissection in Well-Differentiated Thyroid Cancer

  • Chapter
  • First Online:
Evidence-Based Endocrine Surgery

  • 624 Accesses

Abstract

Surgery is considered to be the primary modality of treatment in well-differentiated thyroid cancers. The principles of surgery are to remove the tumor in the thyroid gland and the involved lymph nodes as well as to preserve functions of breathing, speech, and swallowing. Thyroid cancers, particularly papillary thyroid cancers, have a propensity to metastasize to cervical lymph nodes. The first echelon of lymph nodes that are affected are the level VI and VII nodes, known commonly as the central neck nodes. Subsequent echelon of lymph nodes may include the other levels of the neck, collectively known as the lateral neck nodes.

This is a preview of subscription content, log in via an institution to check access.

Access this chapter

Log in via an institution
Chapter
USD 29.95
Price excludes VAT (USA)
  • Available as PDF
  • Read on any device
  • Instant download
  • Own it forever
eBook
USD 79.99
Price excludes VAT (USA)
  • Available as EPUB and PDF
  • Read on any device
  • Instant download
  • Own it forever
Softcover Book
USD 99.99
Price excludes VAT (USA)
  • Compact, lightweight edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info
Hardcover Book
USD 139.99
Price excludes VAT (USA)
  • Durable hardcover edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info

Tax calculation will be finalised at checkout

Purchases are for personal use only

Institutional subscriptions

References

  1. Carty SE, Cooper DS, Doherty GM, Duh QY, Kloos RT, Mandel SJ, Randolph GW, Stack BC Jr, Steward DL, Terris DJ, Thompson GB, Tufano RP, Tutle RM, Udelsman R. Consensus statement on the terminology and classification of central neck dissection for thyroid cancer. Thyroid. 2009;19:1153–8.

    Article  Google Scholar 

  2. Robbins KT, Medina JE, Wolfe GT, Levine PA, Sessions RB, Pruet CW. Standardizing neck dissection terminology. Arch Otolaryngol Head Neck Surg. 1991;117:601–5.

    Article  CAS  Google Scholar 

  3. Kupferman ME, Patterson M, Mandel SJ, LiVolsi V, Weber RS. Patterns of lateral neck metastasis in papillary thyroid carcinoma. Arch Otolaryngol Head Neck Surg. 2004;130:857–60.

    Article  Google Scholar 

  4. Sivanandan R, Soo KC. Pattern of cervical lymph node metastases from papillary carcinoma of the thyroid. Br J Surg. 2001;88(9):1241–4.

    Article  CAS  Google Scholar 

  5. Ji YB, Lee DW, Song CM, Kim KR, Prk CW, Tae K. Accuracy of intraoperative determination of central node metastasis by the surgeon in papillary thyroid carcinoma. Otolaryngol Head Neck Surg. 2014;150(4):542–7.

    Article  Google Scholar 

  6. Nixon IJ, Wang LY, Ganly I, Patel SG, Morris LG, Migliacci JC, Tuttle RM, Shah JP, Shaha AR. Outcomes for patients with papillary thyroid cancer who do not undergo prophylactic central neck dissection. Br J Surg. 2016;103:218–25.

    Article  CAS  Google Scholar 

  7. Lang BH, Ng SH, Lau LL, Cowling BJ, Wong KP, Wan KY. A systematic review and meta-analysis of prophylactic central neck dissection on short-term locoregional recurrence in papillary thyroid carcinomaafter total thyroidectomy. Thyroid. 2013;23(9):1087–98.

    Article  Google Scholar 

  8. Qu H, Sun GR, Liu Y, He QS. Clinical risk factors for central lymph node metastasis in papillary carcinoma: a systematic review and meta-analysis. Clin Endocrinol. 2015;83(1):124–32.

    Article  Google Scholar 

  9. Suman P, Wang CH, Abadin SS, Moo-Young TA, Prinz RA, Winchester DJ. Risk factors for central lymph node metastasis in papillary thyroid carcinoma: a National Cancer Data Base (NCDB) study. Surgery. 2016;159:31–9.

    Article  Google Scholar 

  10. Mitchell AL, Gandhi A, Scott-Coombes D, Prros P. Management of thyroid cancer: United Kingdom National Multidisciplinary Guidelines. J Laryngol Otol. 2016;130:S150–60.

    Article  CAS  Google Scholar 

  11. Haugen BR, Alexander EK, Bible KC, Doherty GM, Mandel SJ, Nikiforov YE, Pacini F, Randolph GW, Sawka AM, Schlumberger M, Schuff KG, Sherman SI, Sosa JA, Steward DL, Tuttle RM, Wartofsky L. 2015 American Thyroid Association Management Guidelines for adult patients with thyroid nodules and differentiated thyroid cancer: the American Thyroid Association Guidelines Task Force on thyroid nodules and differentiated thyroid cancer. Thyroid. 2016;26(1):1–133.

    Article  Google Scholar 

  12. Su W, Lan X, Zhang H, Dong W, Wang Z, He L, Zhang T, Liu S. Risk factors for central lymph node metastasis in cN0 papillary thyroid carcinoma. A systematic review and meta-analysis. PLoS One. 2015;10(10):e0139021.

    Article  Google Scholar 

  13. Ma B, Wang Y, Yang S, Ji Q. Predictive factors for central lymph node metastasis in patients with cN0 paillary thyrod carcinoma: a systematic review and meta-analysis. Int J Surg. 2016;28:153–61.

    Article  Google Scholar 

  14. Kazure HS, Roman SA, Sosa JA. Aggressive variants of papillary thyroid cancer: incidence, characteristics and predictors of survival among 43,738 patients. Ann Surg Oncol. 2012;19(6):1874–80.

    Article  Google Scholar 

  15. Pezzi TA, Sandulache VC, Pezzi CM, Turkeltaub AE, Feng L, Cabillanas ME, Williams MD, Lai SY. Treatment and survival of patients with insular thyroid carcinoma: 508 cases from the National Cancer Data Base. Head Neck. 2016;38(6):906–12.

    Article  Google Scholar 

  16. Joo JY, Park JY, Yoon YH, Choi B, Kim JM, Jo YS, Shong M, Koo BS. Prediction of occult centra lymph node metastasis in papillary thyroid carcinoma by preoperative BRAF analysis using fine-needle aspiration biopsy: prospective study. J Clin Endocrinol Metab. 2012;97(11):3996–4003.

    Article  CAS  Google Scholar 

  17. Stack BC, Ferris RL, Goldenburg D, Hayman M, Shaha A, Sheth S, Sosa JA, Tufano RP. American Thyroid Association consensus review and statement regarding anatomy, terminology and rationale for lateral neck dissection in differentiated thyroid cancer. Thyroid. 2012;22(5):501–8.

    Article  Google Scholar 

  18. Hwang HS, Orloff LA. Efficacy of preoperative neck ultrasound in the detection of cervical lymph node metastasis from thyroid cancer. Laryngoscope. 2011;121(30):487–91.

    Article  Google Scholar 

  19. Randolph GW, Duh QY, Heller KS, LiVolsi VA, Mandel SJ, Steward DL, Tufaano RP, Tuttle RM. The prognostic significance of nodal metastases from papillary thyroid carcinoma can be stratified based on the size and number of metastatic lymph nodes, as well as the presence of extranodal extension. Thyroid. 2012;22(11):1144–52.

    Article  Google Scholar 

  20. Madenei AL, Caragaciance D, Boeckmann JO, Stack BC Jr, Shin JJ. Lateral neck dissection for well differentiated thyroid carcinoma: a systematic review. Laryngoscope. 2014;124(7):1724–34.

    Article  Google Scholar 

  21. Ahn D, Sohn JH, Kim JH, Shin CM, Jeon JH, Park JY. Preoperative subclinical hypothyroidism in patients with papillary thyroid carcinoma. Am J Otolaryngol. 2013;34(4):312–9.

    Article  Google Scholar 

  22. Ahuja AT, Ying M. Sonographic evaluation of cervical lymph nodes. Am J Roentgenol. 2005;184(5):1691–9.

    Article  Google Scholar 

  23. Morita S, Mizoguchi K, Suzuki M, Lizuka K. The accuracy of (18)[F]-fluoro-2-deoxy-D-glucose-positron emission tomography/computed tomography, ultrasonography, and enhanced computed tomography alone in the preoperative diagnosis of cervical lymph node metastasis in patients with papillary thyroid carcinoma. World J Surg. 2010;34(11):2564–9.

    Article  Google Scholar 

  24. Wang LY, Palmer FL, Thomas D, Shaha AR, Shah JP, Patel SG, Tuttle RM, Ganly I. Pre-operative neck ultrasound in clinical node-negative differentiated thyroid cancer. J Clin Endocrinol Metab. 2014;99(10):3686–93.

    Article  CAS  Google Scholar 

  25. Dralle H, Sekulla C, Lorenz K, Brauckhoff M, Machens A. German IONM study group. Intraoperative monitoring of the recurrent laryngeal nerve in thyroid surgery. World J Surg. 2008;32(7):1358–66.

    Article  CAS  Google Scholar 

  26. Chisholm EJ, Kulinskava E, Tolley NS. Systematic review and meta-analysis of the adverse effects of thyroidectomy combined with central neck dissection as compared with thyroidectomy alone. Laryngoscope. 2009;119(6):1135–9.

    Article  Google Scholar 

  27. Shan CX, Zhang W, Jiang DZ, Zheng XM, Liu S, Qiu M. Routine central neck dissection in differentiated thyroid carcinoma: a systematic review and meta-analysis. Laryngoscope. 2012;122(4):797–804.

    Article  Google Scholar 

  28. Kim SK, Woo JW, Lee JH, Park I, Choe JH, Kim JH, Kim JS. Prophylactic central neck dissection might not be necessary in papillary thyroid carcinoma: analysis of 11,569 cases from a single institution. J Am Coll Surg. 2016;222(5):853–64.

    Article  Google Scholar 

  29. Zhao W, You L, Hou X, Chen S, Ren X, Chen G, Zhao Y. The effect of prophylactic central neck dissection (pCND) on locoregional recurrence in papillary thyroid cancer after total thyroidectomy: systematic review and meta-analysis: pCND for the locoregional recurrence of papillary thyroid cancer. Ann Surg Oncol. 2017;24:2189–98.

    Article  Google Scholar 

  30. Polistena A, Monacelli M, Lucchini R, Tviola R, Conti C, Avenia S, Barillaro I, Sanguinetti A, Avenia N. Surgical morbidity of cervical lymphadenopathy for thyroid cancer: a retrospective cohort study over 25 years. Int J Surg. 2015;21:128–34.

    Article  Google Scholar 

  31. McMullen C, Rocke D, Freeman J. Complications of bilateral neck dissection in thyroid cancers from a single high-volume center. JAMA Otolaryngol Head Neck Surg. 2017;143:376–81.

    Article  Google Scholar 

  32. Ahn D, Sohn JH, Jeong JY. Chyle fistula after neck dissection: an 8-year, single-center, prospective study of incidence, clinical features, and treatment. Ann Surg Oncol. 2015;22(Suppl):S1000–6.

    Article  Google Scholar 

  33. Roh JL, Kim DH, Park CI. Prospective identification of chyle leakage in patients undergoing lateral neck dissection for metastatic thyroid cancer. Ann Surg Oncol. 2008;15(2):424–9.

    Article  Google Scholar 

Download references

Author information

Authors and Affiliations

  1. Department of Otolaryngology, National University of Singapore, Singapore, Singapore

    Kwok Seng Loh

  2. Department of Otolaryngology Head and Neck Surgery, National University Hospital, Singapore, Singapore

    Donovon Kum Chuen Eu

Authors
  1. Kwok Seng Loh
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Donovon Kum Chuen Eu
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Kwok Seng Loh .

Editor information

Editors and Affiliations

  1. Division of Endocrine Surgery, National University Hospital, Singapore, Singapore

    Rajeev Parameswaran

  2. Department of Endocrine Surgery, SGPGI Hospital, Lucknow, India

    Amit Agarwal

Rights and permissions

Reprints and permissions

Copyright information

© 2018 Springer Science+Business Media Singapore

About this chapter

Check for updates. Verify currency and authenticity via CrossMark

Cite this chapter

Loh, K.S., Eu, D.K.C. (2018). Neck Dissection in Well-Differentiated Thyroid Cancer. In: Parameswaran, R., Agarwal, A. (eds) Evidence-Based Endocrine Surgery. Springer, Singapore. https://doi.org/10.1007/978-981-10-1124-5_9

Download citation

  • DOI: https://doi.org/10.1007/978-981-10-1124-5_9

  • Published:

  • Publisher Name: Springer, Singapore

  • Print ISBN: 978-981-10-1123-8

  • Online ISBN: 978-981-10-1124-5

  • eBook Packages: MedicineMedicine (R0)

Publish with us

Policies and ethics

Search

Navigation