DOI: https://doi.org/10.22141/2224-0721.14.8.2018.154855

Lymph node dissection in differentiated thyroid cancer: review of modern tendencies

V.A. Smoliar, О.А. Tovkay, V.О. Palamarchuk, V.G. Khoperiya

Abstract


Recently, there has been a significant increase in the incidence of thyroid cancer (TC), both due to the adverse environmental effects and the rapid development of imaging methods. This led to the search for adapted and less aggressive therapeutic protocols, avoiding the risk of complications and inadequate interventions. Despite the predominantly favorable prognosis for differentiated thyroid cancer (DTC), the presence of metastases to the lymph nodes is associated with an increased risk of relapse, which significantly deteriorates the quality of life and adversely affects the prognosis of the disease. Currently, TC treatment is being carried out in general surgical hospitals, which is accompanied by a large number of inadequately executed surgical procedures and a high frequency of postoperative complications. In addition, in our country, radioiodine therapy remains unavailable to most patients, and there is no registry of this pathology to assess the effectiveness of treatment. Taking into account the latest guidelines of endocrine societies, we analyzed the main approaches to determining the indications and volume of lymph node dissection for DTC in terms of their benefits and risks. The literature data showed that the discussion is still open, and surgeons are divided between supporters and opponents of its use. That is why there is a need for additional clinical and perspective long-term randomized studies of prognostically significant factors when choosing approaches to lymph node dissection in DTC.

Keywords


differentiated thyroid cancer; lymph node dissection; review

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