Removing Lymph Nodes with Thyroid Cancers

Thyroid cancers treated with prophylactic central neck lymph-node dissection

(RxWiki News) Cancer surgery is a fine line between removing too little and leaving cancer behind, and removing too much at cost to the patient's quality of life.

A recent review of surgical results has led to the recommendation that nearby lymph nodes should be removed during thyroid surgery as the advantages seem straightforward.

"Ask your surgeon about prophylactic lymph node dissection."

"We found that re-operation rates due to cancer were lower in patients who had routine removal of these lymph nodes, which suggests a more thorough surgical clearance of disease," said the study's senior author, Dr. Michael Yeh, a professor of surgery at the University of California, Los Angeles.

"Our findings may help add to growing evidence that this additional procedure, performed during initial thyroid surgery, may be helpful in management of papillary thyroid cancer."

Researchers examined data on 606 patients in the USA, England and Australia, finding that overall cancer recurrence was 6.9 percent.

For the patients in the study who had their neck lymph nodes taken out in advance, cancer recurrence was substantially lower at 1.5 percent.

Researchers feel that aggressive treatment by removing lymph nodes in advance is more important than in other cancers studied because the thyroid cancer metastases are frequently very tiny, fairly difficult to detect on laboratory studies and easy to miss in a physical exam since so many things are going on in the neck.

For the same reason, the many sensitive structures in the area of the thyroid, researchers were concerned that increased surgical complications would result from more extensive surgery. No evidence for that theory was found other than a slight, but temporary, increase in blood calcium levels for patients who had their lymph nodes removed.

Research was published in the journal Surgery.

No public financial disclosures were made by the authors of the study.

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Review Date: 
May 3, 2012