DECISION TO
OPERATE FOR CERVICAL NODAL RECURRENCE IN THYROID CANCER FOLLOWING THYROIDECTOMY
AND LYMPH NODE DISSECTION
IS IT
AFFECTED BY THE PRESENCE OF DISTANT METASTASES?
The
decision to operate for recurrent nodal neck disease should be taken after
considering two opposing decision elements: (a) risks of revision surgery
(typically higher than primary surgery due to scarring from previous surgery)
(b) surgical resection is the optimal treatment for macroscopic gross nodal
disease. Surgical expertise specifically regarding the performance of revision
thyroid cancer nodal surgery is required from the part of the operating
surgeon. This type of surgery is technically demanding and requires discrete
surgical skill. The presence of distant metastatic disease and the rapidity of
its evolution (indicating disease’s aggressiveness) should be taken into consideration
in the process of therapeutic decision-making. However, reoperation for
treatment of nodal recurrence may be undertaken even in the presence of known
distant metastatic disease for palliation of symptoms (when present) and/or
prevention of aerodigestive tract obstruction.
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