Modified neck dissection for patients with nonadvanced, differentiated carcinoma of the thyroid

Abstract

Abstract To determine if it is truly unnecessary to perform modified neck dissection in nonadvanced, differentiated thyroid carcinoma, the extent of metastases in regional lymph nodes in 586 patients were studied. Four hundred and fifteen patients (70.8%) underwent neck dissections, and lymph node metastasis was disclosed in 339 cases (81.7%). Of the 78 cases judged as stage N0 during the operation, histological examination revealed metastasis in 34 cases (43.6%). Metastatic nodes were found in the central region in 300 cases (72.3%) and within the jugular region in 278 cases (67.0%). Neck dissections were carried out in 277 of 401 nonadvanced cases and in 138 of 185 advanced cases. In the former, metastasis was disclosed in the central region in 68.6% and within the jugular region in 62.1%. In the latter, on the contrary, the percentages were 79.7% and 76.8%, respectively . It is evident from these data that it is not reasonable to judge the presence of lymph node metastasis during operation, and that lymph node metastases are found in patients with nonadvanced disease as frequently as in patients with advanced disease. It is suggested that adequate modified neck dissection should be performed even in patients with nonadvanced, differentiated carcinoma of the thyroid .