Optimal treatment for differentiated thyroid carcinoma is controversial with respect to the extent of thyroid resection, the extent and technique of nodal dissection and use of prophylactic radioiodine treatment. Postoperative complications, such as recurrent laryngeal nerve injury and definitive hypoparathyroidism, have carried great weight in the discussion regarding how radical the surgical treatment should be. The discussion of whether total thyroidectomy or lesser procedures should be the treatment for thyroid carcinomas has been protracted. Now, reasonable agreement exists that total thyroidectomy is the best treatment and the focus of the discussion has moved to the treatment of lymph nodes. At the time of diagnosis, node metastases are a common finding in patients with differentiated thyroid cancer, in particular papillary carcinoma. The argument supporting a radical approach to lymph node excision is that the presence of node metastases increases the recurrence rate. Advocates for the conservative approach believe that little association exists between node metastases and death from thyroid carcinoma. This paper reviews relevant medical literature published in the English language on surgery of lymph nodes in differentiated thyroid cancer with well-controlled trials. Searches were last updated in June 2006.

Surgery of lymph nodes in papillary thyroid cancer / G. Dionigi, R. Dionigi, L. Bartalena, L. Boni, F. Rovera, F. Villa. - In: EXPERT REVIEW OF ANTICANCER THERAPY. - ISSN 1473-7140. - 6:9(2006), pp. 1217-1229. [10.1586/14737140.6.9.1217]

Surgery of lymph nodes in papillary thyroid cancer

G. Dionigi;L. Boni;
2006

Abstract

Optimal treatment for differentiated thyroid carcinoma is controversial with respect to the extent of thyroid resection, the extent and technique of nodal dissection and use of prophylactic radioiodine treatment. Postoperative complications, such as recurrent laryngeal nerve injury and definitive hypoparathyroidism, have carried great weight in the discussion regarding how radical the surgical treatment should be. The discussion of whether total thyroidectomy or lesser procedures should be the treatment for thyroid carcinomas has been protracted. Now, reasonable agreement exists that total thyroidectomy is the best treatment and the focus of the discussion has moved to the treatment of lymph nodes. At the time of diagnosis, node metastases are a common finding in patients with differentiated thyroid cancer, in particular papillary carcinoma. The argument supporting a radical approach to lymph node excision is that the presence of node metastases increases the recurrence rate. Advocates for the conservative approach believe that little association exists between node metastases and death from thyroid carcinoma. This paper reviews relevant medical literature published in the English language on surgery of lymph nodes in differentiated thyroid cancer with well-controlled trials. Searches were last updated in June 2006.
Lymph node metastases; Mini-invasive video-assisted central compartment nodes clearance; Neuromonitoring; Sentinel lymph node biopsy; Staging; Surgery; Thyroid cancer; Will Rogers phenomenon
Settore MED/18 - Chirurgia Generale
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Utilizza questo identificativo per citare o creare un link a questo documento: https://hdl.handle.net/2434/882471
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