Central lymph node dissection (CLND) remains an important component of the surgical treatment of differentiated thyroid cancer. The indication for CLND is the presence of image-positive metastases in level VI lymph nodes; the elective dissection of radiographically normal central compartment lymph nodes in patients with differentiated thyroid cancer remains controversial. The different types of CLND will be discussed herein, and some of the surrounding controversies will be highlighted.
There are over 37,000 new cases of thyroid cancer diagnosed each year in the USA, with the incidence increased two- to three-fold over the last few decades . The increasing incidence has been largely due to the increased diagnosis of differentiated thyroid cancer (DTC) . Although the mortality rates are higher in patients with more extensive disease or in those with more aggressive histology , survival rates are generally excellent, and local–regional recurrence is perhaps a more appropriate outcome measure in patients with DTC .