We have located links that may give you full text access.
Journal Article
Review
Controversy surrounding the role for routine central lymph node dissection for differentiated thyroid cancer.
Current Opinion in Oncology 2010 January
PURPOSE OF REVIEW: Differentiated thyroid cancer (DTC), with a rapidly increasing incidence is the most common endocrine malignancy, but with generally favorable survival. Total thyroidectomy with 'therapeutic' cervical lymph node dissection for involved lymph nodes is the standard of care. A more controversial topic is whether routine 'prophylactic' central lymph node dissection (CLND) in patients without evidence of lymph node metastasis should be performed in patients with DTC, as suggested by several recent management guidelines.
RECENT FINDINGS: A number of retrospective studies suggest that regional lymph node metastases are associated with tumor recurrence and adverse survival. CLND is associated with a higher rate of postoperative athyroglobulinemia and may modify the indications for radioactive iodine treatment. Current guidelines from the American Thyroid Association suggest that prophylactic CLND may be performed for papillary thyroid cancer, especially for advanced tumors (T3 and T4).
SUMMARY: Recent studies and the arguments for and against prophylactic CLND are reviewed. There is currently a trend toward more aggressive surgical therapy, including prophylactic CLND and avoidance of radioactive iodine treatment for DTC, when appropriate. Randomized prospective controlled trials are lacking at this point to determine the role of prophylactic CLND in the management of DTC.
RECENT FINDINGS: A number of retrospective studies suggest that regional lymph node metastases are associated with tumor recurrence and adverse survival. CLND is associated with a higher rate of postoperative athyroglobulinemia and may modify the indications for radioactive iodine treatment. Current guidelines from the American Thyroid Association suggest that prophylactic CLND may be performed for papillary thyroid cancer, especially for advanced tumors (T3 and T4).
SUMMARY: Recent studies and the arguments for and against prophylactic CLND are reviewed. There is currently a trend toward more aggressive surgical therapy, including prophylactic CLND and avoidance of radioactive iodine treatment for DTC, when appropriate. Randomized prospective controlled trials are lacking at this point to determine the role of prophylactic CLND in the management of DTC.
Full text links
Related Resources
Trending Papers
Challenges in Septic Shock: From New Hemodynamics to Blood Purification Therapies.Journal of Personalized Medicine 2024 Februrary 4
Molecular Targets of Novel Therapeutics for Diabetic Kidney Disease: A New Era of Nephroprotection.International Journal of Molecular Sciences 2024 April 4
The 'Ten Commandments' for the 2023 European Society of Cardiology guidelines for the management of endocarditis.European Heart Journal 2024 April 18
A Guide to the Use of Vasopressors and Inotropes for Patients in Shock.Journal of Intensive Care Medicine 2024 April 14
Get seemless 1-tap access through your institution/university
For the best experience, use the Read mobile app
All material on this website is protected by copyright, Copyright © 1994-2024 by WebMD LLC.
This website also contains material copyrighted by 3rd parties.
By using this service, you agree to our terms of use and privacy policy.
Your Privacy Choices
You can now claim free CME credits for this literature searchClaim now
Get seemless 1-tap access through your institution/university
For the best experience, use the Read mobile app