The thyroid gland, or simply the thyroid, in vertebrate anatomy, is one of the largest endocrine glands and consists of two connected lobes. The thyroid gland is found in the neck, below the thyroid cartilage. The thyroid gland controls how quickly the body uses energy, makes proteins, and controls how sensitive the body is to other hormones.
In France, a total thyroidectomy is recommended for the treatment of differentiated thyroid carcinoma (DTC) diagnosed at the pre- or peroperative stage. This recommendation is in line with the European and American thyroid guidelines. However, when suspicious macroscopic cervical lymph nodes are identified during preoperative work-up or during surgery, a lymph node dissection (LND) and total thyroidectomy are recommended due to the favourable impact on survival and loco-regional recurrence rates in high- and low-risk patients, respectively. Nonetheless, prophylactic LND associated with a total thyroidectomy remains controversial. No prospective study has yet established the benefits of prophylactic LND with regard to the risks of recurrence and mortality related to the DTC. Furthermore, the majority of clinicians consider that radioiodine ablation therapy should only be used in selective patients (i.e., patients with metastasis, incomplete tumour resection, or high-risk patients based on the pTNM classification or well-established criteria), because the radioiodine is aimed both at ablating normal remnants and treating known or suspected persistent neoplastic foci or residual lymph node metastases.
Last date updated on June, 2014