Abstract
Program Description: A tremendous amount of debate has occurred since the 2006 and 2009 ATA guidelines made recommendation regarding the indications for central and lateral neck lymph node surgery in patients with well-differentiated thyroid cancer. While consensus has yet to be reached, several pivotal issues have been defined and are the target of prospective randomized trials. The panelists will identify these key issues and answer the following questions: 1) What is the prevailing clinical approach in 2011? 2) What is the best evidence available that governs this approach? 3) What are the future opportunities for refining our understanding? Specific issues that will be explored include: 1) Lateral neck surgery - when and how much? Which levels should be addressed? 2) Has there been a change in the epidemiology of well-differentiated thyroid cancer? How has this impacted neck disease and survival? What is the appropriate threshold for nodal surgery after prior thyroidectomy? 3) What is the evidence for elective central neck dissection (pro and con)? 4) How do we best determine where the disease is located? What is the optimal way to define the extent of surgery? 5) Putting it all together, how do I approach the neck in a patient with early and advanced well-differentiated thyroid cancer? This will be an interactive panel with plentiful discussion and questions from the audience and case-based analysis. The panelists will move toward consensus when possible regarding each of these issues and help provide a framework for investigation and validation of proposed management algorithms.
Educational Objectives: 1) Understand which levels should be addressed in undertaking lateral neck surgery for thyroid cancer. 2) Recognize changes in epidemiology of thyroid cancer and impact on neck disease and survival. 3) Become familiar with optimal determination of the location of disease and therefore extent of surgery.
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