Surgical diagnosis: frozen section and the extent of surgery

This article outlines features of the biology of well differentiated thyroid cancer, and how these impact on systems of risk prediction. It covers salient points that the surgeon should consider from the clinical history and examination in the office, and outlines the procedures available for surgical management of thyroid cancer. The article then examines the choices that face thyroid surgeons both in relation to planning primary thyroid surgery and the approach to regional lymphadenectomy. In addition, key findings in the operating room are discussed in relation to their impact on decision making. Long-term outcomes are presented for patients following surgery.