EXTENT OF LATERAL NECK DISSECTION FOR DIFFERENTIATED THYROID CANCER: THE CONTROVERSY THEN AND NOW
Journal Title: World Journal of Pharmaceutical and Medical Research - Year 2018, Vol 4, Issue 1
Abstract
The study aims to review the literature regarding extent of lateral neck dissection for differentiated thyroid cancer by way of a systematic review. Though there is abundant data available on outcomes of lateral neck dissection in relation to differentiated thyroid cancer, including some international guidelines, there is no clear consensus which is accepted throughout the world. Apart from this, the findings of some new studies cast serious doubt on the current treatment practices, which necessitates a thorough review of all available evidence to bring out latest inferences. Purpose: To review the literature regarding extent of lateral neck dissection for differentiated thyroid cancer by way of a systematic review. Though there is abundant data available on outcomes of lateral neck dissection in relation to differentiated thyroid cancer, including some international guidelines, there is no clear consensus which is accepted throughout the world. Apart from this, the findings of some new studies cast serious doubt on the current treatment practices, which necessitates a thorough review of all available evidence to bring out latest inferences. Materials and Methods: An electronic search was conducted using the terms ―PTC or thyroid neoplasms or papillary carcinoma‖, ―neck dissection‖, ―lateral or cervical lymphadenopathy‖ and ―differentiated thyroid cancer‖ in combination with the following search strategy : Search block Thyroid Neoplasms - "Thyroid Neoplasms"[Mesh] OR thyroid neoplasm*[tiab] OR thyroid cancer*[tiab] OR thyroid tumor*[tiab] OR thyroid tumour*[tiab] OR thyroid carcinoma*[tiab] OR thyroid malignancy*[tiab] OR thyroid oncology*[tiab] OR dtc[tiab] OR ptc[tiab]; Search block Neck Dissection - "Neck Dissection"[Mesh] OR neck dissection*[tiab] OR cervical lymphadenectomy*[tiab] OR lateral lymphadenopathy*[tiab] OR cervical lymphadenopathy*[tiab]. Clinical studies were retrieved from the electronic databases of PubMed, EMBASE and SCOPUS which had been published till June 2017. These included prospective studies, randomized controlled trials, retrospective studies and smaller descriptive studies. References of the selected studies were further searched for relevant articles. Apart from this, a search was conducted over Google Scholar to obtain related articles. Results and Conclusion: After an exhaustive review of all available evidence, it can be stated that treatment decisions regarding extent of lateral neck dissection for differentiated thyroid cancer should be guided by presence of various risk factors discussed in this study, in addition to comprehensive preoperative evaluation of the lateral neck with physical examination, ultrasonography and FNAC. Apart from this intraoperative frozen section of central and jugular lymph nodes should be carried out when required. Future perspectives would involve exploring the role of sentinel lymph node biopsy from lateral neck.
Authors and Affiliations
Dr. Jaspreet Singh Badwal
Keywords
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