Methods

Methods

To obtain a multidisciplinary consensus statement on the terminology and classification of the central neck dissection for thyroid cancer, a surgery working group was established within the American Thyroid Association (ATA). The need for this working group was recognized by the ATA guidelines taskforce on thyroid cancer. Experts in thyroid cancer representing the fields of endocrinology, endocrine surgery, otolaryngology—head and neck surgery, and radiology were assembled by the ATA in consultation with the American Association of Endocrine Surgeons, the American Academy of Otolaryngology—Head and Neck Surgery, and the American Head and Neck Society. These experts are the authors of this article. All authors were involved in the discussion and participated in manuscript development. In addition to a review of the literature relevant to the central neck compartment anatomy, neck dissection classification and terminology, as well as central neck dissection for thyroid cancer, the authors solicited and considered recommendations from other experts within the fields of endocrinology, endocrine surgery, and otolaryngology—head and neck surgery. Articles were identified by searching MEDLINE using the following search terms: {CENTRAL NECK DISSECTION} or {ANTERIOR NECK DISSECTION} or {CENTRAL NECK COMPARTMENT} and {THYROID} and {CANCER} or {CARCINOMA}. Emphasis was placed on papers published between 1991 and 2008, following publication of the widely adopted report by Robbins et al., standardizing neck dissection terminology (3). Despite this original report and subsequent updates (4,5), there remains controversy regarding the inferior extent of the central neck dissection, validity of unilateral versus bilateral central neck dissection, and inconsistent terminology regarding indications such as routine rather than therapeutic versus prophylactic=elective. The level of evidence primarily relied upon for the development of this article was expert opinion. The preliminary meeting of this group occurred at the ATA annual meeting in October 2007 with subsequent meetings in July and October 2008. Supplementing these meetings were multiple teleconferences and detailed electronic mail communications culminating in acceptance by the ATA Board of Directors. Additionally, this manuscript was also formally endorsed by the Boards of the American Academy of Otolaryngology—Head Neck Surgery, American Association of Endocrine Surgeons, and American Head Neck Society.