Redefining classification of central neck dissection in differentiated thyroid cancer

Head & Neck ◽  
2013 ◽  
Vol 36 (2) ◽  
pp. 286-290 ◽  
Author(s):  
Edward D. McAlister ◽  
David P. Goldstein ◽  
Lorne E. Rotstein
Keyword(s):  
Thyroid Cancer ◽  
Neck Dissection ◽  
Differentiated Thyroid Cancer ◽  
Central Neck Dissection ◽  
Central Neck

scholarly journals Differentiated Thyroid Cancer: Indications and Extent of Central Neck Dissection—Our Experience

2013 ◽  
Vol 2013 ◽  
pp. 1-7 ◽  
Author(s):  
Pietro Giorgio Calò ◽  
Fabio Medas ◽  
Giuseppe Pisano ◽  
Francesco Boi ◽  
Germana Baghino ◽  
...  
Keyword(s):  
Thyroid Cancer ◽  
High Risk ◽  
Neck Dissection ◽  
Preoperative Diagnosis ◽  
Differentiated Thyroid Cancer ◽  
Central Neck Dissection ◽  
Central Neck ◽  
Group A ◽  
Cell Variant ◽  
Group B

The aim of this retrospective study was to determine the rate of metastases in the central neck compartment and examine the morbidity and rate of recurrence in patients with differentiated thyroid cancer treated with or without a central neck dissection. Two hundred and fifteen patients undergoing total thyroidectomy with preoperative diagnosis of differentiated thyroid cancer, in the absence of suspicious nodes, were divided in two groups: those who underwent a thyroidectomy only (group A; ) and those who also received a central neck dissection (group B; ). Five cases (2.32%) of nodal recurrence were observed: 3 in group A and 2 in group B. Tumor histology was associated with a risk of recurrence: Hürthle cell-variant and tall cell-variant carcinomas were associated with a high risk of recurrence. Multifocality and extrathyroidal invasion also presented a higher risk, while smaller tumors were at lower risk. The results of this study suggest that prophylactic central neck dissection should be reserved for high-risk patients only. A wider use of immunocytochemical and genetic markers to improve preoperative diagnosis and the development of methods for the intraoperative identification of metastatic lymph nodes will be useful in the future for the improved selection of patients for central neck dissections.

scholarly journals Consensus Statement on the Terminology and Classification of Central Neck Dissection for Thyroid Cancer

Thyroid ◽  
2009 ◽  
Vol 19 (11) ◽  
pp. 1153-1158 ◽  
Author(s):  
Sally E. Carty ◽  
David S. Cooper ◽  
Gerard M. Doherty ◽  
Quan-Yang Duh ◽  
Richard T. Kloos ◽  
...  
Keyword(s):  
Thyroid Cancer ◽  
Neck Dissection ◽  
Consensus Statement ◽  
Central Neck Dissection ◽  
Central Neck

Disparities in the Care of Differentiated Thyroid Cancer in the United States: Exploring the National Cancer Database

2017 ◽  
Vol 83 (7) ◽  
pp. 739-746 ◽  
Author(s):  
Kathryn Jaap ◽  
Rebekah Campbell ◽  
James Dove ◽  
Marcus Fluck ◽  
Marie Hunsinger ◽  
...  
Keyword(s):  
Thyroid Cancer ◽  
Neck Dissection ◽  
Differentiated Thyroid Cancer ◽  
The United States ◽  
Central Neck Dissection ◽  
Hazard Ratio ◽  
National Cancer Database ◽  
Central Neck ◽  
Uninsured Patients ◽  
Black Patients

Differentiated thyroid cancer (DTC) treatment is multifaceted, and may be influenced by socio-economic factors. The goal of this study is to examine disparities in DTC treatment. DTC patients from 1998 to 2012 were identified using the National Cancer Database. DTC was identified in 262,041 patients. The mean age was 48.2. The majority of patients (52%) received care at Comprehensive Community Cancer Programs (CCCPs). Total thyroidectomy was less common at Community Cancer Programs (CCPs) [odds ratio (OR): 0.735; 95% confidence interval (CI): 0.707–0.764), and more common at academic centers (OR: 1.129; 95% CI: 1.102–1.157) compared with CCCP. A central neck dissection was performed most often at academic center (20.6%) versus CCP (10.0%). Black patients were less likely to undergo central neck dissection compared with white patients (OR: 0.468; 95% CI: 0.452–0.484). Patients more likely to receive radioactive iodine were white compared with black patients (hazard ratio: 0.833; 95% CI: 0.806–0.861), privately insured compared with uninsured patients (hazard ratio: 1.272; 95% CI: 1.210–1.341), and patients treated at CCCP. Disparities exist in DTC treatment. Individuals at risk for under-treatment are black patients, uninsured patients, and those treated at CCP. As the Affordable Care Act changes access to health care, future studies will be needed to readdress disparities.

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