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Management of the Central and Lateral Neck in Patients with Differentiated Thyroid Cancer

  • Surgical Oncology (A. Tufaro, Section Editor)
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Abstract

Purpose of Review

The incidence of differentiated thyroid cancer, including papillary, follicular, and Hürthle cell histologies, is increasing rapidly in the United States. It is associated with significant risk of locoregional lymph node metastasis; this is especially true for papillary thyroid cancer (PTC), which now accounts for approximately 90 % of all new thyroid cancer diagnoses. Overall, differentiated thyroid cancer is associated with a good prognosis and excellent long-term survival.

Recent Findings

There is contentious debate about the merits of prophylactic central compartment lymph node dissection for this disease, as there has not been convincing evidence to support it; a randomized controlled trial is unlikely. There are nuances in best practice for management and surveillance of patients with a history of nodal disease, as they are at increased risk for recurrence.

Summary

This is a comprehensive review of the literature, including the recently published American Thyroid Association (ATA) guidelines for the management of thyroid nodules and differentiated thyroid cancer in adult patients, focusing on the management of nodal disease.

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Authors and Affiliations

  1. Section of Endocrine Surgery, Department of Surgery, Duke Raleigh Medical Center, 3404 Wakeforest Rd Ste 202, Raleigh, NC, 27609, USA

    Michael T. Stang

  2. Department of Surgery, Duke University Medical Center #2945, Seeley Mudd Building 466C, Durham, NC, 27710, USA

    Syed Ammer Shah

  3. Section of Endocrine Surgery, Department of Surgery, Duke University Medical Center #2945, Seeley Mudd Building Office 484, Durham, NC, 27710, USA

    Julie A. Sosa

  4. Endocrine Neoplasia Diseases Group, Duke Cancer Institute and Duke Clinical Research Institute, Duke University Medical Center, Durham, NC, 27710, USA

    Julie A. Sosa

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  1. Michael T. Stang
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Correspondence to Julie A. Sosa.

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Conflict of Interest

Dr. Sosa is a member of the Data Monitoring Committee, Medullary Thyroid Cancer Consortium Registry, funded by Novo Nordisk, GlaxoSmithKline, Astra Zeneca, and Eli Lilly. Drs. Stang and Shah declare no conflicts of interest.

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This article does not contain any studies with human or animal subjects performed by any of the authors.

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This article is part of the Topical collection on Surgical Oncology.

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Stang, M.T., Shah, S.A. & Sosa, J.A. Management of the Central and Lateral Neck in Patients with Differentiated Thyroid Cancer. Curr Surg Rep 4, 24 (2016). https://doi.org/10.1007/s40137-016-0147-0

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