Papillary thyroid carcinoma: Debate at rest.

ABSTRACT

Introduction: Papillary thyroid cancer (PTC) is the most common well-differentiated cancer of the thyroid and is one of the fastest growing group of cancers probably because of the increased use of ultrasound (HRUSG) in the evaluation of the thyroid in recent years. Materials and Methods: A MEDLINE and OVID database search was performed to collect information on papillary thyroid carcinoma. Recently published consensus guidelines were also used as an additional resource. Conclusions: The controversy regarding the extent of thyroidectomy in patients of PTC is relatively settled, with total thyoidectomy being the preferred approach with nodules >1.5 cm in size. Lymph node (LN) metastases do not seem to affect the overall survival, but they do increase the recurrence rate. It is worthwhile to offer LN dissection at initial surgery if LNs are ultrasonologically diagnosed to harbor malignancy. In experts hands, the rate of recurrent laryngeal nerve injury and hypoparathyroidism is negligible in a neck dissection in initial surgery and remains negligible if carried out in a redo or completion scenario.