Management of the Neck in Well-Differentiated Thyroid Cancer

Panagiotis Asimakopoulos, Ashok R. Shaha, Iain J. Nixon, Jatin P. Shah, Gregory W. Randolph, Peter Angelos, Mark E. Zafereo, Luiz P. Kowalski, Dana M. Hartl, Kerry D. Olsen, Juan P. Rodrigo, Vincent Vander Poorten, Antti A. Mäkitie, Alvaro Sanabria, Carlos Suárez, Miquel Quer, Francisco J. Civantos, K. Thomas Robbins, Orlando Guntinas-Lichius, Marc HamoirAlessandra Rinaldo, Alfio Ferlito

Research output: Contribution to journalReview articlepeer-review

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. Summary: 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.

Original languageEnglish (US)
Article number1
JournalCurrent oncology reports
Volume23
Issue number1
DOIs
StatePublished - Jan 2021

Keywords

  • Lymphatic metastasis
  • Neck dissection
  • Thyroid neoplasms

ASJC Scopus subject areas

  • Oncology

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