Surgical morbidity of cervical lymphadenectomy for thyroid cancer: A retrospective cohort study over 25 years

Abstract

Central and lateral cervical lymph node dissection are associated to severe morbidity. Correct indication, surgical expertise, high volume of patients and early multidisciplinary management of complications is the key of an acceptable balance between oncologic benefits and surgical morbidity.

The Role of Calcitonin in Predicting the Extent of Surgery in Medullary Thyroid Carcinoma: A Nationwide Population-Based Study in Norway

“…Lateral lymph node dissection includes the risk of surgical complications, with nerve injuries as the most severe among these [26, 27]. The dilemma then is the possible presence of undetectable micrometastases versus the risk of morbidity due to prophylactic lateral lymph node dissection.…”

Surgeon volume and prognosis of patients with advanced papillary thyroid cancer and lateral nodal metastasis

“…This is an important point as surgery or RAI treatment in PTC is related to increased morbidity that could decrease the patient's quality of life. Hypocalcaemia, recurrent nerve injury and scarring are surgical complications of PTC, and therapeutic RAI has also been shown to cause various complications such as sialadenitis, gonadal damage and secondary cancers. From a socioeconomic perspective, the burden of thyroid cancer is increasing worldwide, and a large portion of the cost is from treatment.…”

A Nationwide Study of Multiple Endocrine Neoplasia Type 2A in Norway: Predictive and Prognostic Factors for the Clinical Course of Medullary Thyroid Carcinoma

“…In this study as well, the risk increased with the dissection of lymph node compartments. If the parathyroid cannot be preserved in situ, parathyroid auto transplantation in the sternocleidomastoid muscle is recommended (206,207).…”

“…Following lateral neck dissection, nerve injury to the accessory nerve gives the most severe morbidity, resulting in reduced mobility of the shoulder and pain (206,207,212). At neck dissection in the lateral left side of the neck, injury to the thoracic duct at the junction of the subclavian and internal jugular vein may occur (207,213). The fistula might heal by conservative medical treatment like nutritional and pharmacological treatment (213), such as total parenteral nutrition and Somatostatin.…”