Guidelines from the Brazilian society of surgical oncology regarding indications and technical aspects of neck dissection in papillary, follicular, and medullary thyroid cancers
ABSTRACT Objective: The purpose of these guidelines is to provide specific recommendations for the surgical treatment of neck metastases in patients with papillary, follicular, and medullary thyroid carcinomas. Materials and methods: Recommendations were developed based on research of scientific a...
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| Format: | Article |
| Language: | English |
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Brazilian Society of Endocrinology and Metabolism
2023-05-01
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| Series: | Archives of Endocrinology and Metabolism |
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| Online Access: | http://www.scielo.br/scielo.php?script=sci_arttext&pid=S2359-39972023000400400&lng=en&tlng=en |
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| author | Terence Farias Luiz Paulo Kowalski Fernando Dias Carlos S. Ritta Barreira José Guilherme Vartanian Marcos Roberto Tavares Fernanda Vaisman Denise Momesso Alexandre Ferreira Oliveira Rodrigo Nascimento Pinheiro Heber Salvador de Castro Ribeiro |
| author_facet | Terence Farias Luiz Paulo Kowalski Fernando Dias Carlos S. Ritta Barreira José Guilherme Vartanian Marcos Roberto Tavares Fernanda Vaisman Denise Momesso Alexandre Ferreira Oliveira Rodrigo Nascimento Pinheiro Heber Salvador de Castro Ribeiro |
| author_sort | Terence Farias |
| collection | DOAJ |
| description | ABSTRACT Objective: The purpose of these guidelines is to provide specific recommendations for the surgical treatment of neck metastases in patients with papillary, follicular, and medullary thyroid carcinomas. Materials and methods: Recommendations were developed based on research of scientific articles (preferentially meta-analyses) and guidelines issued by international medical specialty societies. The American College of Physicians’ Guideline Grading System was used to determine the levels of evidence and grades of recommendations. The following questions were answered: A) Is elective neck dissection indicated in the treatment of papillary, follicular, and medullary thyroid carcinoma? B) When should central, lateral, and modified radical neck dissection be performed? C) Could molecular tests guide the extent of the neck dissection? Results/conclusion: Recommendation 1: Elective central neck dissection is not indicated in patients with cN0 well-differentiated thyroid carcinoma or in those with noninvasive T1 and T2 tumors but may be considered in T3-T4 tumors or in the presence of metastases in the lateral neck compartments. Recommendation 2: Elective central neck dissection is recommended in medullary thyroid carcinoma. Recommendation 3: Selective neck dissection of levels II–V should be indicated to treat neck metastases in papillary thyroid cancer, an approach that decreases the risk of recurrence and mortality. Recommendation 4: Compartmental neck dissection is indicated in the treatment of lymph node recurrence after elective or therapeutic neck dissection; “berry node picking” is not recommended. Recommendation 5: There are currently no recommendations regarding the use of molecular tests in guiding the extent of neck dissection in thyroid cancer. |
| first_indexed | 2024-03-13T08:44:17Z |
| format | Article |
| id | doaj.art-9afa5d212a5c4a5ca6436adf67fb86bc |
| institution | Directory Open Access Journal |
| issn | 2359-4292 |
| language | English |
| last_indexed | 2024-03-13T08:44:17Z |
| publishDate | 2023-05-01 |
| publisher | Brazilian Society of Endocrinology and Metabolism |
| record_format | Article |
| series | Archives of Endocrinology and Metabolism |
| spelling | doaj.art-9afa5d212a5c4a5ca6436adf67fb86bc2023-05-30T07:34:44ZengBrazilian Society of Endocrinology and MetabolismArchives of Endocrinology and Metabolism2359-42922023-05-0167410.20945/2359-3997000000607Guidelines from the Brazilian society of surgical oncology regarding indications and technical aspects of neck dissection in papillary, follicular, and medullary thyroid cancersTerence Fariashttps://orcid.org/0000-0001-7287-5736Luiz Paulo Kowalskihttps://orcid.org/0000-0002-0481-156XFernando Diashttps://orcid.org/0000-0003-1000-7436Carlos S. Ritta Barreirahttps://orcid.org/0000-0002-2126-1811José Guilherme Vartanianhttps://orcid.org/0000-0003-1995-6742Marcos Roberto Tavareshttps://orcid.org/0000-0002-9244-7058Fernanda Vaismanhttps://orcid.org/0000-0002-6835-7108Denise Momessohttps://orcid.org/0000-0001-6296-2721Alexandre Ferreira Oliveirahttps://orcid.org/0000-0002-7500-6752Rodrigo Nascimento Pinheirohttps://orcid.org/0000-0002-2715-7628Heber Salvador de Castro Ribeirohttps://orcid.org/0000-0002-3412-7451ABSTRACT Objective: The purpose of these guidelines is to provide specific recommendations for the surgical treatment of neck metastases in patients with papillary, follicular, and medullary thyroid carcinomas. Materials and methods: Recommendations were developed based on research of scientific articles (preferentially meta-analyses) and guidelines issued by international medical specialty societies. The American College of Physicians’ Guideline Grading System was used to determine the levels of evidence and grades of recommendations. The following questions were answered: A) Is elective neck dissection indicated in the treatment of papillary, follicular, and medullary thyroid carcinoma? B) When should central, lateral, and modified radical neck dissection be performed? C) Could molecular tests guide the extent of the neck dissection? Results/conclusion: Recommendation 1: Elective central neck dissection is not indicated in patients with cN0 well-differentiated thyroid carcinoma or in those with noninvasive T1 and T2 tumors but may be considered in T3-T4 tumors or in the presence of metastases in the lateral neck compartments. Recommendation 2: Elective central neck dissection is recommended in medullary thyroid carcinoma. Recommendation 3: Selective neck dissection of levels II–V should be indicated to treat neck metastases in papillary thyroid cancer, an approach that decreases the risk of recurrence and mortality. Recommendation 4: Compartmental neck dissection is indicated in the treatment of lymph node recurrence after elective or therapeutic neck dissection; “berry node picking” is not recommended. Recommendation 5: There are currently no recommendations regarding the use of molecular tests in guiding the extent of neck dissection in thyroid cancer.http://www.scielo.br/scielo.php?script=sci_arttext&pid=S2359-39972023000400400&lng=en&tlng=enThyroid carcinomasurgical treatmentpapillary thyroid cancermedullary thyroid cancerfollicular thyroid cancerlymph node metastasiselective neck dissectiontherapeutic neck dissectionmolecular testsindicationsguidelines |
| spellingShingle | Terence Farias Luiz Paulo Kowalski Fernando Dias Carlos S. Ritta Barreira José Guilherme Vartanian Marcos Roberto Tavares Fernanda Vaisman Denise Momesso Alexandre Ferreira Oliveira Rodrigo Nascimento Pinheiro Heber Salvador de Castro Ribeiro Guidelines from the Brazilian society of surgical oncology regarding indications and technical aspects of neck dissection in papillary, follicular, and medullary thyroid cancers Archives of Endocrinology and Metabolism Thyroid carcinoma surgical treatment papillary thyroid cancer medullary thyroid cancer follicular thyroid cancer lymph node metastasis elective neck dissection therapeutic neck dissection molecular tests indications guidelines |
| title | Guidelines from the Brazilian society of surgical oncology regarding indications and technical aspects of neck dissection in papillary, follicular, and medullary thyroid cancers |
| title_full | Guidelines from the Brazilian society of surgical oncology regarding indications and technical aspects of neck dissection in papillary, follicular, and medullary thyroid cancers |
| title_fullStr | Guidelines from the Brazilian society of surgical oncology regarding indications and technical aspects of neck dissection in papillary, follicular, and medullary thyroid cancers |
| title_full_unstemmed | Guidelines from the Brazilian society of surgical oncology regarding indications and technical aspects of neck dissection in papillary, follicular, and medullary thyroid cancers |
| title_short | Guidelines from the Brazilian society of surgical oncology regarding indications and technical aspects of neck dissection in papillary, follicular, and medullary thyroid cancers |
| title_sort | guidelines from the brazilian society of surgical oncology regarding indications and technical aspects of neck dissection in papillary follicular and medullary thyroid cancers |
| topic | Thyroid carcinoma surgical treatment papillary thyroid cancer medullary thyroid cancer follicular thyroid cancer lymph node metastasis elective neck dissection therapeutic neck dissection molecular tests indications guidelines |
| url | http://www.scielo.br/scielo.php?script=sci_arttext&pid=S2359-39972023000400400&lng=en&tlng=en |
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