Guideline for the Surgical Management of Locally Invasive Differentiated Thyroid Cancer From the Korean Society of Head and Neck Surgery

Jun Ook Park, Joo Hyun Kim, Young Hoon Joo, Sang Yeon Kim, Geun Jeon Kim, Hyun Bum Kim, Dong Hyun Lee, Hyun Jun Hong, Young Min Park, Eun Jae Chung, Yong Bae Ji, Kyoung Ho Oh, Hyoung Shin Lee, Dong Kun Lee, Ki Nam Park, Myung Jin Ban, Bo Hae Kim, Do Hun Kim, Jae Keun Cho, Dong Bin AhnMin Su Kim, Jun Girl Seok, Jeon Yeob Jang, Hyo Geun Choi, Hee Jin Kim, Sung Joon Park, Eun Kyung Jung, Yeon Soo Kim, Yong Tae Hong, Young Chan Lee, Ho Ryun Won, Sung Chan Shin, Seung Kuk Baek, Soon Young Kwon

Research output: Contribution to journalArticlepeer-review

1 Citation (Scopus)


The aim of this study was to develop evidence-based recommendations for determining the surgical extent in patients with locally invasive differentiated thyroid cancer (DTC). Locally invasive DTC with gross extrathyroidal extension invading surrounding anatomical structures may lead to several functional deficits and poor oncological outcomes. At present, the optimal extent of surgery in locally invasive DTC remains a matter of debate, and there are no adequate guidelines. On October 8, 2021, four experts searched the PubMed, Embase, and Cochrane Library databases; the identified papers were reviewed by 39 experts in thyroid and head and neck surgery.The Grading of Recommendations Assessment, Development and Evaluation (GRADE) approach was used to assess the quality of evidence, and to develop and report recommenda-tions. The strength of a recommendation reflects the confidence of a guideline panel that the desirable effects of an inter-vention outweigh any undesirable effects, across all patients for whom the recommendation is applicable. After completing the draft guidelines, Delphi questionnaires were completed by members of the Korean Society of Head and Neck Surgery. Twenty-seven evidence-based recommendations were made for several factors, including the preoperative workup; surgical extent of thyroidectomy; surgery for cancer invading the strap muscles, recurrent laryngeal nerve, laryngeal framework, trachea, or esophagus; and surgery for patients with central and lateral cervical lymph node involvement. Evidence-based guidelines were devised to help clinicians make safer and more efficient clinical decisions for the optimal surgical treatment of patients with locally invasive DTC.

Original languageEnglish
Pages (from-to)1-19
Number of pages19
JournalClinical and Experimental Otorhinolaryngology
Issue number1
Publication statusPublished - 2023 Feb

Bibliographical note

Publisher Copyright:
© 2023 by Korean Society of Otorhinolaryngology-Head and Neck Surgery.


  • Esophagus
  • Guidelines
  • Lymph Nodes
  • Recurrent Laryngeal Nerve
  • Thyroidectomy
  • Trachea

ASJC Scopus subject areas

  • Surgery
  • Otorhinolaryngology


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