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Article: The pros and cons of routine central compartment neck dissection for clinically nodal negative (cN0) papillary thyroid cancer

TitleThe pros and cons of routine central compartment neck dissection for clinically nodal negative (cN0) papillary thyroid cancer
Authors
KeywordsCentral compartment neck dissection
Nodal negative papillary thyroid cancer
Prophylactic central neck dissection (pCND)
Issue Date2013
PublisherAME Publishing Company. The Journal's web site is located at http://www.glandsurgery.org/index
Citation
Gland Surgery, 2013, v. 2 n. 4, p. 186-195 How to Cite?
AbstractMetastatic disease to regional lymph nodes (LNs) is common in papillary thyroid carcinoma (PTC). LN dissection is increasingly performed as part of the surgical management of PTC. The role of prophylactic central neck dissection (pCND) in PTC is unclear. There is limited evidence to support a routine pCND in clinical setting for nodal negative (cN0) PTC. The aim of this review was to examine the pros and cons of prophylactic neck dissection in cN0 PTC. In summary, the advantages of pCND are: removal of the central LNs that potentially harbor micro-metastases, more accurate staging of disease in order to plan more individualized management, reducing the need for re-operation to remove the metastatic LNs which have developed later and possible improvement in overall survival. The disadvantages are: an extensive surgery but lack of evidence of survival benefit, higher incidence of complications with little impact on local recurrence rate, possibility of over treating in cN0 patients and it does not sound like a cost effective approach in the management of small thyroid cancer. Considering low frequency of permanent morbidity, some authors believe that prophylactic neck dissection is safe in experienced hands even though its prognostic benefit has yet to be demonstrated.
Persistent Identifierhttp://hdl.handle.net/10722/193221
ISSN

 

DC FieldValueLanguage
dc.contributor.authorChan, ACen_US
dc.contributor.authorLang, BHHen_US
dc.contributor.authorWong, KPen_US
dc.date.accessioned2013-12-20T02:37:39Z-
dc.date.available2013-12-20T02:37:39Z-
dc.date.issued2013en_US
dc.identifier.citationGland Surgery, 2013, v. 2 n. 4, p. 186-195en_US
dc.identifier.issn2227-684X-
dc.identifier.urihttp://hdl.handle.net/10722/193221-
dc.description.abstractMetastatic disease to regional lymph nodes (LNs) is common in papillary thyroid carcinoma (PTC). LN dissection is increasingly performed as part of the surgical management of PTC. The role of prophylactic central neck dissection (pCND) in PTC is unclear. There is limited evidence to support a routine pCND in clinical setting for nodal negative (cN0) PTC. The aim of this review was to examine the pros and cons of prophylactic neck dissection in cN0 PTC. In summary, the advantages of pCND are: removal of the central LNs that potentially harbor micro-metastases, more accurate staging of disease in order to plan more individualized management, reducing the need for re-operation to remove the metastatic LNs which have developed later and possible improvement in overall survival. The disadvantages are: an extensive surgery but lack of evidence of survival benefit, higher incidence of complications with little impact on local recurrence rate, possibility of over treating in cN0 patients and it does not sound like a cost effective approach in the management of small thyroid cancer. Considering low frequency of permanent morbidity, some authors believe that prophylactic neck dissection is safe in experienced hands even though its prognostic benefit has yet to be demonstrated.-
dc.languageengen_US
dc.publisherAME Publishing Company. The Journal's web site is located at http://www.glandsurgery.org/index-
dc.relation.ispartofGland Surgeryen_US
dc.rightsCreative Commons: Attribution 3.0 Hong Kong License-
dc.subjectCentral compartment neck dissection-
dc.subjectNodal negative papillary thyroid cancer-
dc.subjectProphylactic central neck dissection (pCND)-
dc.titleThe pros and cons of routine central compartment neck dissection for clinically nodal negative (cN0) papillary thyroid canceren_US
dc.typeArticleen_US
dc.identifier.emailLang, BHH: Blang@hku.hken_US
dc.identifier.authorityLang, HHB=rp01828en_US
dc.description.naturepublished_or_final_version-
dc.identifier.doi10.3978/j.issn.2227-684X.2013.10.10-
dc.identifier.hkuros227071en_US
dc.identifier.volume2en_US
dc.identifier.issue4en_US
dc.identifier.spage186en_US
dc.identifier.epage195en_US
dc.publisher.placeHong Kong-

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