464 patients with differentiated thyroid carcinoma were scored and tre
ated using a risk-oriented management scheme employing early surgical
re-intervention including compartment-oriented lymph-node dissection i
n cases of lymph-node metastases or local recurrences without routine
external radiotherapy. A multivariate analysis showed that there was n
o effect of lymph-node metastases on survival. The difference in survi
val between patients with (24%) and without (76%) lymph-node metastase
s (univariate analysis) were due to the coincidence of higher tumor st
age (T-4) and higher incidence oi peripheral metastases (M(1)). Thus,
provided surgery is efficient, N-1 is not a risk factor influencing su
rvival.