Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2014 Feb;34(1):9-14.

Central neck dissection in differentiated thyroid cancer: technical notes

G Giugliano  1 , M Proh  1 , B Gibelli  1 , E Grosso  1 , M Tagliabue  1 , E De Fiori  2 , F Maffini  3 , F Chiesa  1 , M Ansarin  1
Affiliations

Central neck dissection in differentiated thyroid cancer: technical notes

G Giugliano et al. Acta Otorhinolaryngol Ital. 2014 Feb.

Abstract
in English, Italian

Differentiated thyroid cancers may be associated with regional lymph node metastases in 20-50% of cases. The central compartment (VIupper VII levels) is considered to be the first echelon of nodal metastases in all differentiated thyroid carcinomas. The indication for central neck dissection is still debated especially in patients with cN0 disease. For some authors, central neck dissection is recommended for lymph nodes that are suspect preoperatively (either clinically or with ultrasound) and/or for lymph node metastases detected intra-operatively with a positive frozen section. In need of a better definition, we divided the dissection in four different areas to map localization of metastases. In this study, we present the rationale for central neck dissection in the management of differentiated thyroid carcinoma, providing some anatomical reflections on surgical technique, oncological considerations and analysis of complications. Central neck dissection may be limited to the compartments that describe a predictable territory of regional recurrences in order to reduce associated morbidities.

I tumori differenziati della tiroide possono essere associati a metastasi linfonodali regionali nel 20-50% dei casi. Il compartimento centrale (VI livello – VII livello superiore) è considerato la prima sede di metastasi linfonodali in tutti i carcinomi tiroidei differenziati. L'indicazione per la dissezione del centrale (CND) è ancora in discussione soprattutto in pazienti cN0. Per alcuni autori, la dissezione centrale è raccomandata solo in pazienti sospetti preoperatoriamente (clinicamente o alla ecografia) e/o per metastasi linfonodali rilevate intraoperativamente. Per una migliore definizione abbiamo diviso la dissezione in quattro diverse aree per mappare la localizzazione delle metastasi. In questo studio presentiamo il razionale per la dissezione centrale del collo in pazienti affetti da carcinoma differenziato della tiroide, fornendo alcune considerazioni anatomiche sulla tecnica chirurgica, considerazione oncologiche e l'analisi delle complicanze. La dissezione centrale del collo potrebbe essere limitata ai compartimenti che descrivono un'area prevedibile di recidive locali, al fine di ridurre la morbilità.

Keywords: Central neck dissection; Thyroid cancer.

PubMed Disclaimer

Figures

Fig. 1.
Fig. 1.
Standard classification for neck node levels.
Fig. 2.
Fig. 2.
Central neck sub-compartment. The author's classification.
Fig. 3.
Fig. 3.
View of surgical specimen: thyroid gland and central compartment nodes.
See this image and copyright information in PMC

Similar articles

See all similar articles

Cited by

See all "Cited by" articles

References

    1. Hundahl SA, Fleming ID, Fremgen AM, et al. A national cancer data base report on 53,856 cases of thyroid carcinoma treated in the US, 1985-1995. Cancer. 1998;83:2638–2648. - PubMed
    1. Cooper DS, Doherty GM, Haugen BR, et al. Management guidelines for patients with thyroid nodules and differentiated thyroid cancer. Thyroid. 2006;16:109–142. - PubMed
    1. McConahey WM, Hay ID, Woolner LB, et al. Papillary thyroid cancer treated at the Mayo Clinic, 1946 through 1970: initial manifestations, pathologic findings, therapy, and outcome. Mayo Clin Proc. 1986;61:978–996. - PubMed
    1. Mazzaferri EL, Jhiang SM. Long-term impact of initial surgical and medical therapy on papillary and follicular thyroid cancer. Am J Med. 1994;97:418–428. - PubMed
    1. Sato N, Oyamatsu M, Koyama Y, et al. Do the level of nodal disease according to the TNM classification and the number of involved cervical nodes reflect prognosis in patients with differentiated carcinoma of the thyroid gland? J Surg Oncol. 1998;69:151–155. - PubMed

LinkOut - more resources