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Surgery for Advanced Nodal Metastasis in Thyroid Cancer
Int J Thyroidol 2018;11(2):117-122
Published online November 30, 2018;
© 2018 Korean Thyroid Association.

Min Woo Park and Young Soo Rho

Department of Otorhinolaryngology-Head and Neck Surgery, Kangdong Sacred Heart Hospital, Ilsong Memorial Head and Neck Thyroid Cancer Hospital, Hallym University College of Medicine, Seoul, Korea
Correspondence to: Young Soo Rho, MD, PhD, Department of Otorhinolaryngology-Head and Neck Surgery, Kangdong Sacred Heart Hospital, 150 Seongan-ro, Gangdong-gu, Seoul 05355, Korea
Tel: 82-2-2240-2279, Fax: 82-2-482-2279, E-mail:
This is a review article for 12th Bumsan Academic Awards.
Received September 20, 2018; Revised November 22, 2018; Accepted November 22, 2018.
This is an open-access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (, which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.
Metastases to regional cervical lymph nodes occur frequently in patients with thyroid cancer. The appropriate management of regional lymph node is important to achieve good disease control and to classify risk stratification for adjuvant radioactive iodine. However, there are some occasions that neck dissection is difficult and embarrassing in thyroid cancer. Especially, extensive or unusual nodal metastases bring challenges and makes neck dissection more difficult. Carotid artery management is one of the most difficult procedure in neck dissection. The management of patients who have persistent or recurrent cervical metastasis involving the carotid artery has been controversial and treatment dilemma to the surgeon. Metastasis of well differentiated thyroid cancer to the retropharyngeal lymph nodes is rare but occasionally encountered. The complete surgical excision is usually recommended for retropharyngeal lymph node metastasis of well differentiated thyroid cancer. An extensive mediastinal dissection in advanced differentiated thyroid carcinoma is occasionally required. This paper will review recent reports of management of advanced nodal metastasis of thyroid cancer and share the author’s personal experience.
Keywords : Thyroid cancer, Carotid artery, Retropharyngeal lymph node, Mediastinal lymph node, Surgery

November 2018, 11 (2)