American Thyroid Association Consensus Review and Statement Regarding the Anatomy, Terminology, and Rationale for Lateral Neck Dissection in Differentiated Thyroid Cancer
Exclusive author commentary
Stack BC et al. – Lateral neck lymph nodes are a significant consideration in the surgical management of patients with differentiated thyroid cancer (DTC). When current guidelines formulated by the American Thyroid Association (ATA) and by other international medical societies are followed, initial evaluation of the DTC patient with ultrasound (or other modalities when indicated) will help to identify lateral neck lymph nodes of concern. These findings should be addressed using fine–needle aspiration biopsy. A comprehensive neck dissection of at least nodal levels IIa, III, IV, and Vb should be performed when indicated to optimize disease control.Methods
- A literature review followed by formulation of a consensus statement was performed.
- Four proposals regarding management of the lateral neck are made for consideration by organizations developing management guidelines for patients with thyroid nodules and DTC including the next iteration of management guidelines developed by the American Thyroid Association (ATA).
- Metastases to lateral neck nodes must be considered in the evaluation of the newly diagnosed thyroid cancer patient and for surveillance of the previously treated DTC patient.
Brendan C. Stack (05/21/2012) comments:
The goal of this activity of the surgical affairs committee of the American Thyroid Association was to highlight the significance of the lateral neck in the management of thyroid cancer and to set the stage for guideline revisions regarding lateral neck management.