PAPILLARY THYROID CARCINOMA TREATMENT - IS THE PENDULUM SHIFTING?

INTRODUCTION: The incidence of papillary thyroid carcinoma has been on the rise in the past few decades while the disease specific mortality remains stable. During prophylactic central neck dissection (level 6), an average of 60% positive occult lymph nodes metastasis are found, hence the justification for performing a prophylactic central neck dissection. The opponents for performing neck dissection claim that the disease specific mortality is low regardless of the operation and that adding a neck dissection will, significantly, increase surgical morbidity. Guidelines regarding prophylactic central neck dissection differ between countries and cultures. The difficulty to determine unequivocal guidelines is due to the scarcity of randomized controlled trials to assess the effectiveness of prophylactic neck dissection. In this literature review we will explore data in favor and against prophylactic central neck dissection for patients with papillary thyroid carcinoma.