Decision making for the central compartment in differentiated thyroid cancer Journal Article
| Authors: | Gonçalves Filho, J.; Zafereo, M. E.; Ahmad, F. I.; Nixon, I. J.; Shaha, A. R.; Vander Poorten, V.; Sanabria, A.; Hefetz, A. K.; Robbins, K. T.; Kamani, D.; Randolph, G. W.; Coca-Pelaz, A.; Simo, R.; Rinaldo, A.; Angelos, P.; Ferlito, A.; Kowalski, L. P. |
| Article Title: | Decision making for the central compartment in differentiated thyroid cancer |
| Abstract: | The central compartment is a common site for nodal spread from differentiated thyroid carcinoma, often occurring in patients without clinical or ultrasonographic (US) evidence of neck lymph node metastasis (cN0). However, the role of elective central compartment neck dissection (CND) among patients with DTC remains controversial. We performed a systematic literature review, also including review of international guidelines, with discussion of anatomic and technical aspects, as well as risks and benefits of performing elective CND. The recent literature does not uniformly support or refute elective CND in patients with DTC, and therefore an individualized approach is warranted which considers individual surgeon experience, including individual recurrence and complication rates. Patients (especially older males) with large tumors (>4 cm) and extrathyroidal extension are more likely to benefit from elective CND, but elective CND also increases risk for hypoparathyroidism and recurrent nerve injury, especially when operated by low-volume surgeons. Individual surgeons who perform elective CND must ensure the number of central compartment dissections needed to prevent one recurrence (number needed to treat) is not disproportionate to their individual number of central compartment dissections per related complication (number needed to harm). © 2018 |
| Keywords: | surgical technique; review; cancer recurrence; neck dissection; cancer risk; cancer staging; outcome assessment; lymph node metastasis; preoperative evaluation; practice guideline; risk factor; risk assessment; postoperative complication; systematic review; thyroidectomy; surgery; clinical decision making; thyroid cancer; cervical lymph node; surgical anatomy; hypoparathyroidism; elective surgery; randomized controlled trial (topic); meta analysis (topic); differentiated thyroid cancer; central compartment; level vi; anatomical concepts; lymph node metastases; recurrent laryngeal nerve injury; human; priority journal; central compartment metastasis; central compartment neck dissection; low volume surgeon |
| Journal Title: | European Journal of Surgical Oncology |
| Volume: | 44 |
| Issue: | 11 |
| ISSN: | 0748-7983 |
| Publisher: | Elsevier Inc. |
| Date Published: | 2018-11-01 |
| Start Page: | 1671 |
| End Page: | 1678 |
| Language: | English |
| DOI: | 10.1016/j.ejso.2018.08.005 |
| PUBMED: | 30145001 |
| PROVIDER: | scopus |
| DOI/URL: | |
| Notes: | Review -- Export Date: 1 November 2018 -- Source: Scopus |
