Compartment-mediated dissection for papillary thyroid cancer

There is considerable controversy surrounding the appropriate treatment of papillary thyroid carcinoma (PTC), most of which centers around the extent of thyroidectomy. Despite the advocation of less than total thyroidectomy b y many surgeons, there is a renewed interest by others, mainly in Europe an d Japan, in the performance of routine total thyroidectomy and extensive ly mph-node dissection for PTC. This has been shown to be an effective strateg y for medullary thyroid carcinoma, which is not responsive to thyroid suppr ession or radioactive iodine treatment. PTC, however, is well treated by th ese adjuvant modalities and, in general, has an excellent prognosis. The be nefit of extensive operations for routine cases of PTC has not been proven, and this practice is not employed by most surgeons in the United States. N ode dissection is reserved for those patients with palpable adenopathy.