Prophylactic Neck Surgery in Low-Risk Thyroid Cancer: Insights w/ Dr. Hartl

We are honored to have Dr. Dana Hartl present "Risk Staging With Prophylactic Unilateral Central Neck Dissection in Low-risk Papillary Thyroid Carcinoma." Dr. Mark Zafereo joins as the featured expert discussant. 0:00 Webinar 2:55 Dr. Hartl presents 4:00 The Dilemma of Prophylactic Neck Dissection Dr. Hartl introduces the dilemma surrounding prophylactic neck dissection (PND) in patients who are clinically negative for papillary thyroid carcinoma (PTC) on ultrasound. She advocates that PND in the central neck may help in treatment decision-making, specifically in the realm of postoperative radioiodine therapy. 7:00 Thyroid Fashion Trends in France Dr. Hartl presents a new method of performing thyroid lobectomy and prophylactic central neck dissection as a staging procedure for low risk tumors. In a retrospective study, her team investigated the rate of upstaging for clinically low-risk PTC patients to the American Thyroid Association's (ATA) intermediate or high-risk classification for patients undergoing PND. The methodology, objective, and findings of the study are discussed here. 17:30 Balancing Upstaging & Over-treatment Dr. Hartl discusses the drawbacks of the study. She explains that since patients are upstaged after PND, such a diagnostic procedure could expose patients with clinically row-risk tumors to unnecessary over-treatment with the likelihood of an insignificant improvement in oncological outcome. Furthermore, PND diagnosis' impact on RAI treatment remains unclear, while molecular analysis of disease tends to better guide optimal RAI therapy. 23:39 Discussion and Q&A w/ Dr. Zafereo Dr. Zafereo and Dr. Hartl discuss a variety of clinical considerations for treating low-risk patients with thyroid carcinoma including selecting unilateral surgery for smaller thyroid tumors, managing total thyroidectomies versus thyroid lobectomies, treating positive lymph nodes as identified during the time of surgery, and radioactive iodine decision-making for patients with BRAF+ disease. ** Check out our other programs! ** The THANC Guide https://thancguide.org/ TIRO: Thyroid Int'l Recommendations Online https://tiro.expert/ ** Follow us on Twitter! ** @thancfoundation - https://shorturl.at/puwS0 THANC on FB - https://shorturl.at/svNY4