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Neck dissection for differentiated thyroid cancer

Rebecca S Sippel, MD, FACS
Section Editor
Sally E Carty, MD, FACS
Deputy Editor
Wenliang Chen, MD, PhD


Differentiated thyroid cancers, including papillary and follicular, account for >90 percent of thyroid cancer patients [1]. While metastatic disease to regional nodes is frequently identified in patients with papillary thyroid cancer, it is very uncommon in patients with follicular cancer.

Cervical lymphadenectomy, or neck dissection, is the treatment of choice when there is evidence of lymph node metastasis from thyroid cancer. In certain situations, a neck dissection can also be performed "prophylactically" at the time of thyroidectomy to avoid a second operation due to recurrence.

In this topic, we discuss various neck dissection techniques and their applications. Techniques of thyroidectomy are discussed in other topics. (See "Initial thyroidectomy".)


The neck is divided into six levels (I to VI) and six sublevels (A or B) with regard to its nodal contents (figure 1 and figure 2) [2]:

Level I – Submental (IA) and submandibular lymph nodes (IB).

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Literature review current through: Oct 2017. | This topic last updated: Oct 11, 2017.
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