BACKGROUND: The optimal treatment of @entity3557 ( @entity3557 ) is still debated, also with respect to nodal treatment. METHOD: Retrospective analysis of a personal series of 159 @entity1 with @entity3557 , with respect to nodal disease, follow up 1-27 (mean 8) years. RESULTS: In 42 @entity1 with clinical, macroscopic nodal disease ( @entity17470 ) a therapeutic lymphadenectomy was performed, with @entity3121 status in 41 (98%) @entity1 . 117 @entity1 had no clinical or intraoperative suspicion of nodal involvement (cN0), with occult nodal disease in 5/29 (17%) @entity1 undergoing prophylactic (elective) lymphadenectomy, and in 2/88 (2.3%) @entity1 without primary lymphadenectomy (metachronous nodal disease) (p < 0.005). Nodal recurrences were observed (1-5 years after primary treatment for cure) in 5/42 (12%) @entity3121 and in 3/114 (2.6%) cN0, pN0 @entity5 (p = 0.009), with unfavourable outcome in 2 and 1 @entity1 , respectively. The 20-year tumor specific survival was 100% in TNM I + II (low risk) @entity1 (including @entity3121 and N0 @entity5 ); the survival rate was deteriorated by stage @entity3121 vs. N0 in TNM high risk @entity1 (50% vs. 86%; p = 0.03). DISCUSSION: The intraoperative macroscopic staging (cN) remains important:--clinical nodal disease warrants a systematic node dissection (microdissection), for preventing (curable or serious) nodal recurrences. Occult nodal disease does not evolve frequently in clinical nodal recurrence. A less radical (and only central) prophylactic lymphadenectomy, avoiding surgical morbidity, may be oncologically adequate. More sensitive detection of nodal positivity (frozen section of sampling tissue or sentinel nodes, immunohistochemistry) appears not rationale. In pN0, cN0 @entity5 use of prophylactic 131I may represent overtreatment, and follow up controls may be conducted less rigorously.

[Which lymphadenectomy in XXXX ?].

@entity3557 :: ('MESH:C536915', 'Disease') :: ['papillary thyroid carcinoma', 'PTC'] @entity1 :: ('9606', 'Species') :: ['patients'] @entity5 :: ('MESH:D009369', 'Disease') :: ['tumors'] @entity17470 :: ('84618', 'Gene') :: ['cN1'] @entity3121 :: ('5270', 'Gene') :: ['pN1']
@entity3557 :: (MESH:C536915,Disease) :: ['papillary thyroid gland carcinoma']
