Indications for Bilateral Modified Radical Neck Dissection in Patients With Papillary Carcinoma of the Thyroid

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Abstract
PAPILLARY THYROID cancer is generally associated with low morbidity and mortality rates; the disease-specific survival rate at 10 years is approximately 90%.1 Despite the overall excellent prognosis, some patients experience recurrent thyroid cancer and die of the disease. The likelihood of disease recurrence varies with several prognostic factors, including age at diagnosis, size of the primary tumor, extracapsular invasion, and the presence of distant metastasis.2-5 However, the effect of lymph node metastasis on survival is controversial.1,6-10 In the early 1970s, our group11 noted a high incidence of nodal metastases in patients with papillary thyroid cancer. Noguchi et al1,12,13 reported lymph node metastasis to be a significant prognostic risk factor and that modified radical neck dissection (MRND) improved the survival of patients with papillary thyroid cancer.