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Paul Lo Gerfo, MD
New York, NY

Arch Surg. 2000;135:1199.

	Since this article does not have an abstract, we have provided the first 150 words of the full text and any section headings.

The authors of this study are advocating prophylactic contralateral modified neck dissection for patients they define as being at high risk for developing contralateral neck disease. These data were based on the fact that contralateral nodal recurrence was associated with a poor prognosis. I believe their data define a group of patients with poor prognosis, but the authors fail to provide data that would indicate that bilateral neck dissection would alter outcome.^1-3

Historically, surgeons in the United States performed prophylactic ipsilateral lymph node dissection in patients diagnosed as having papillary thyroid cancer. Almost all have abandoned this, since the incidence of recurrent disease in patients without clinical evidence of metastasis to the lymph nodes who were not treated with elective neck dissection was much lower than the 30% to 70% of patients with occult metastasis who underwent prophylactic node dissection. Most surgeons came to the conclusion . . . [Full Text of this Article]

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Indications for Bilateral Modified Radical Neck Dissection in Patients With Papillary Carcinoma of the Thyroid
Akira Ohshima, Hiroyuki Yamashita, Shiro Noguchi, Shinya Uchino, Shin Watanabe, Masakatsu Toda, Eisuke Koike, Keisuke Takatu, and Hiroto Yamashita
Arch Surg. 2000;135(10):1194-1198.
ABSTRACT | FULL TEXT