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Lymph node metastases from well-differentiated thyroid cancer. A clinical review.

The records of 77 patients with well-differentiated thyroid cancer and proved lymph node metastases have been reviewed. The control of regional metastases was satisfactory in those with only a few nodes involved when limited dissections were utilized initially. In those patients with more extensive nodal involvement, the ultimate rate of failure to control disease in the neck was unacceptably high among those who initially underwent conservative localized neck dissection. Although regional control will not influence mortality, a more aggressive modified neck dissection is recommended for patients presenting with significant nodal involvement.