Modified Radical Neck Dissection
The role of neck dissection in the management of thyroidcancer is controversial, due to the indolent natural history of mostwell-differentiated thyroid cancers (WDTC), as well as the high prevalence of clinically apparent or occult lymph node metastases. This is particularly true in papillary thyroid carcinoma, where high rates of nodal positivity are found even in microcarcinomas; Wada et al. have reported a 64% rate of nodal metastasis in the central neck and 45% in the lateral neck. Lymph node metastasis is more likely in cancers harboring the BRAF V600E mutation. Despite the high rate of nodal involvement, there are no prospective data on the impact of lateral neck dissection on survival or locoregional recurrence. Although Noguchi et al. reported an improvement in cause-specific survival among patients with WDTC undergoing modified radical neck dissection (MRND), there was no difference in overall survival, and this study was performed in a cohort not receiving adjuvant radioactive iodine therapy.
KeywordsPapillary Thyroid Carcinoma Neck Dissection Sternocleidomastoid Muscle Lateral Neck Radical Neck Dissection
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