Surgical approach to level VI in papillary thyroid carcinoma: an overview.

One of the most controversial issues in the treatment of thyroid cancer is the management of the central neck nodes in patients with papillary thyroid carcinoma (PTC). Lymph node involvement is common in patients with PTC and it may negatively affect recurrence rate and, probably, survival. Although therapeutic compartment-oriented central neck dissection is the standard treatment for patients with clinical nodal involvement (cN1) PTC, the role and the extension for elective or prophylactic central neck dissection (PCND) in patients with clinically node negative (cN0) neoplasms remains controversial. In recent years, in order to decrease the risk of postoperative complications related to PCND, unilateral central neck dissection has emerged as an alternative approach to bilateral central neck dissection.