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Updated: Jul 13, 2026
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"Sun's Seven-Step Technique" for Endoscopic En-Bloc Resection of Thyroid Cancer via the Chest-Breast Approach
Published on: November 28, 2025
Role of lymph node dissection in primary surgery for thyroid cancer
Elizabeth G Grubbs1, Douglas B Evans
1Department of Surgical Oncology, The University of Texas M. D. Anderson Cancer Center, Houston, Texas 77030-1402, USA.
Summary
Preoperative ultrasound is recommended for all thyroid cancer patients to assess lymph node metastasis. This aids in planning compartment-oriented neck dissections for complete surgical removal of disease.
Area of Science:
- Oncology
- Surgical Oncology
- Head and Neck Surgery
Background:
- Management of cervical lymph nodes in thyroid cancer is controversial.
- Even low-risk thyroid cancer patients face significant recurrence risk.
- This necessitates improved preoperative neck evaluation and lymphadenectomy strategies.
Purpose of the Study:
- To recommend a comprehensive preoperative evaluation strategy for thyroid cancer.
- To guide the extent of lymphadenectomy in patients with papillary and medullary thyroid cancer.
Main Methods:
- Utilizing preoperative ultrasound for all thyroid cancer patients undergoing thyroidectomy.
- Employing preoperative ultrasound for recurrent disease surveillance and surgical planning.
- Performing compartment-oriented neck dissection based on ultrasound findings.
Main Results:
- Preoperative ultrasound identifies the extent of lymph node metastases.
- Facilitates complete surgical removal of gross disease in the neck.
- Supports compartment-oriented neck dissection as the optimal surgical approach.
Conclusions:
- Preoperative ultrasound is crucial for evaluating the N0 neck in thyroid cancer.
- It guides surgical management of cervical lymphadenopathy.
- A compartment-oriented neck dissection based on ultrasound findings ensures comprehensive disease removal.
