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g., a BRAF mutation in a papillary tumor), play no role in the current guidelines�� recommendations for the surgical treatment of well-differentiated thyroid carcinoma (9, 11). Recent years have seen a marked increase in the incidental discovery of papillary microcarcinomas (i.e., carcinomas no greater than 10 mm in size), which have a low risk of recurrence or metastasis. It has, therefore, become necessary to distinguish check details low-risk from high-risk tumors in surgical treatment planning, so that low-risk tumors will not be subjected to overly aggressive resection, which would cause more complications without improving oncologic outcomes (Table 2) (12). Non-metastatic papillary microcarcinomas and minimally invasive follicular carcinomas without vascular invasion are low-risk tumors; papillary tumors over 10 mm in size (regardless of their primary metastatic status) and follicular tumors that show vascular invasion or are widely invasive are high-risk tumors (Table 2). Intrathyroid papillary tumors without any clinically demonstrable lymph node metastases (cN0), multifocal papillary microcarcinomas, and minimally invasive oncocytic follicular tumors (H��rthle-cell tumors) seem to occupy an intermediate position between low- and high-risk tumors, and the extent of resection can be planned accordingly; this matter is not yet fully clear. There is, however, an international consensus that extensive resections should be carried out in centers with special expertise to limit the risk of complications, especially postoperative hypoparathyroidism and hypocalcemia (9, 11, 13). Table 2 Recommended extent of resection for papillary and follicular thyroid carcinoma with low, increased, and high risk (summarized from [9]) The classification of the local and regional lymph node system and the concept of lymph node surgery in well-differentiated thyroid carcinoma have met with important refinements in recent years, based on a multitude of studies (16). Prophylactic lymph-node dissection has been found to provide no significant advantage with respect to the risk of local and regional recurrence if there is no clinical or radiological evidence of lymph-node metastases. If the lymph nodes are clinically or radiologically positive, a compartment-oriented lymph-node dissection can lower the rates of recurrence and reoperation (9). More than 90% of localized, well-differentiated carcinomas of the thyroid can now be cured by surgery combined with radioactive iodine therapy (9). Resectability is limited mainly by infiltration of the respiratory or gastrointestinal tracts in the mediastinum. For tumor invasion confined to the neck, various resective techniques have been devised, depending on the site and the longitudinal and transverse extent of the tumor (e.g., so-called fenestration or segmental resection of the trachea).