[Appropriate lymph node dissection in thyroid adenocarcinoma]

Thirty-four patients underwent thyroid surgery for papillary and follicular adenocarcinomas in the period from 1985 to 1989. Fourteen patients were treated with local neck dissection and 20 patients, with modified or radical neck dissection. Cervical lymph node metastasis was found in 25 patients (74%). Our recent policy for lymph node dissection is as follows: When deep cervical lymph node metastasis is clinically demonstrated, radical or modified neck dissection is performed. In patients without clinically demonstrated metastasis, local neck dissection and sampling of the internal jugular chain are performed. When microscopic metastasis is found in frozen sections, modified neck dissection is added. Thus we could select patients for modified neck dissection and choose appropriate neck dissection for more complete cancer clearance without losing postoperative functions.