[Should cervical lymph nodes be electively removed in differentiated thyroid carcinoma?]

Differentiated thyroid carcinomas (DTC; papillary and follicular) constitute merely 0.5-1% of all malignancies in the world. The proper extent of their surgical resection has been discussed for many years. Two different approaches predominate in the literature. One group claims, that elective, modified radical neck dissection (MRND) should be performed. That strategy is supported by high frequency (80%) of observed "occult", clinically not evident, micrometastases in regional lymph nodes on the neck. On the other hand, there have been no studies so far which would unquestionably confirm the prognostic value of neck lymph node involvement in DTC, or the favorable influence of elective lymph node dissection on long-term survival. Therefore, other authors do not recommend prophylactic lateral neck dissection. MRND, apart from its doubtful influence on prognosis, is connected with a higher complication rate and longer hospitalization. The authors of this review also share this opinion.