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Lymph node dissection in papillary or follicular thyroid carcinoma.
Marco Bononi1, Adriano Tocchi, Vincenzo Cangemi
1Department of General Surgery P. Valdoni, First School of Medicine, University of Rome La Sapienza, Italy. marco.bononi@uniroma1.it
Anticancer Research
|August 28, 2004
Summary
For papillary and follicular thyroid cancer, lymphadenectomy is recommended only when necessary. Total thyroidectomy with radiometabolic therapy and hormone suppression is effective, reducing the need for routine lymph node removal.
Area of Science:
- Endocrinology
- Surgical Oncology
- Nuclear Medicine
Background:
- Prospective randomized studies on therapeutic protocols for papillary or follicular thyroid carcinoma are limited.
- While total thyroidectomy is standard, the necessity of locoregional lymphadenectomy remains debated.
Purpose of the Study:
- To evaluate therapeutic protocols for papillary and follicular thyroid carcinoma.
- To assess the role of lymphadenectomy in thyroid cancer treatment.
Main Methods:
- Fifty-four patients with papillary or follicular thyroid carcinoma underwent evaluation and surgical management (total thyroidectomy, lobectomy, or lymphadenectomy).
- Patients received whole body scintigraphy, radiometabolic therapy, and chronic hormone suppressive therapy.
Main Results:
- Fifty-one patients survived, with 3 deaths from unrelated causes.
- Surgical complications included laryngeal nerve impairment and hypoparathyroidism.
- Follow-up ranged from 1 to 139 months.
Conclusions:
- The optimal treatment for lymph node metastases in thyroid cancer is undefined.
- Lymphadenectomy is recommended only when clinically indicated for follicular carcinoma.
- Routine lymphadenectomy is not necessary for occult differentiated thyroid carcinoma.