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Invited Critique
June 15, 2009

Operative Technique for Modified Radical Neck Dissection in Papillary Thyroid Carcinoma—Invited Critique

Arch Surg. 2009;144(6):574. doi:10.1001/archsurg.2009.90

The management of lymph node involvement in PTC is a controversial topic, in part because it is well documented that PTC is a disease with an exceptionally good prognosis. While patients and clinicians can respond emotionally to hearing the word cancer, such responses in PTC can be disproportionate to objective outcomes. Surgeons can exacerbate an emotional reaction with statements such as, “cancer is a surgical disease,” that on the surface seem reasonable. But the facts are that PTC is endemic in the population, frequently involves cervical nodes, and rarely causes mortality after thyroidectomy.

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