[Our surgical strategy for thyroid carcinoma]

According to our previous data on papillary thyroid cancer (PTC), recurrences are related to lymph node ratio (number of metastatic lymph nodes/number of dissected nodes) and lymphatic spread of PTC is more symmetrical than previously thought. Therefore, neck dissection should be performed symmetrically. Our basic procedure for clinically evident PTC is total thyroidectomy with central neck dissection. For the cases with jugular chain adenopathy and/or T3, T4 tumor, bilateral lateral neck dissection should be added. Surgical clearance of malignant tissue is important for curability. For micro PTC (T<1 cm), lobectomy with ipsilateral central neck dissection or careful observation are proposed. Meticulous maneuver of parathyroid glands and recurrent laryngeal nerves is essential for above-mentioned procedure.