INTRODUCTION:
Thyroid carcinoma forms about 1% of all cancers and causes 0.2 % of cancer deaths. The majority of these tumors are of the papillary type which makes up about 80–85 percent of thyroid cancers. Papillary thyroid carcinoma (PTC), out of all thyroid cancers, has the highest incidence of cervical lymph node metastasis which is the most important prognostic factor for loco-regional recurrences in PTC patients. Cervical LN metastasis, however, does not always have a negative impact on overall survival in such patients. The ideal strategy for management of patients with PTC combines complete surgical resection of clinically and radiologically evident disease in the neck, use of radioactive iodine ablation (when indicated), and postoperative TSH suppression.The optimal extent of surgery for cervical LN metastasis in PTC is still up for debate. The majority of researchers accept that pathologically negative neck nodes do not require prophylactic neck dissection. However, some physicians recommend radical neck dissection (RND) for neck nodes that are pathologically positive, while others advise selective neck dissection with restrictions.In general, the extent of therapeutic lateral neck dissection (LND) includes level II–V. However, routine level V lymphadenectomy in patients with PTC with clinically lateral lymph node metastasis remains controversial. An increasing number of recent studies have shown that the incidence of level V lymph node metastasis is significantly lower than the incidence of level II–IV lymph node metastasis.