Central neck dissection in differentiated thyroid cancer: technical notes.
Differentiated thyroid cancers may be associated with regional lymph node metastases in 20-50% of cases. The central compartment (VIupper VII levels) is considered to be the first echelon of nodal metastases in all differentiated thyroid carcinomas. The indication for central neck dissection is still debated especially in patients with cN0 disease. For some authors, central neck dissection is recommended for lymph nodes that are suspect preoperatively (either clinically or with ultrasound) and/or for lymph node metastases detected intra-operatively with a positive frozen section. In need of a better definition, we divided the dissection in four different areas to map localization of metastases. In this study, we present the rationale for central neck dissection in the management of differentiated thyroid carcinoma, providing some anatomical reflections on surgical technique, oncological considerations and analysis of complications. Central neck dissection may be limited to the compartments that describe a predictable territory of regional recurrences in order to reduce associated morbidities.
Division of Head & Neck Surgery.
G
G
Giugliano
Division of Head & Neck Surgery.
M
M
Proh
Division of Head & Neck Surgery.
B
B
Gibelli
Division of Head & Neck Surgery.
E
E
Grosso
Division of Head & Neck Surgery.
M
M
Tagliabue
Division of Diagnostic Radiology.
E
E
De Fiori
Division of Pathology, European Institute of Oncology, Milano, Italy.
F
F
Maffini
Division of Head & Neck Surgery.
F
F
Chiesa
Division of Head & Neck Surgery.
M
M
Ansarin
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D005260:Female; D006801:Humans; D008207:Lymphatic Metastasis; D008297:Male; D008875:Middle Aged; D037981:Neck Dissection / Q000379:methods*; D013964:Thyroid Neoplasms / Q000473:pathology / Q000601:surgery*; D013965:Thyroidectomy
Central neck dissection; Thyroid cancer