Response to Commentary

Excerpt

We appreciate Professor Orlo Clarks’ fine commentary. Recent improvement of the sensitivity of ultrasonography (US) has enabled us to diagnose papillary microcarcinoma (PMC) and evaluate its progression. What is most important is that US-detected lateral metastasis significantly affects the disease-free survival (DFS) of PMC patients [10, 11 in the text]. It is true that the sensitivity of US for lateral node metastasis is low, but as we reported in 2004, lateral node metastasis undetectable by US does not need to be dissected [10]. Since the publication of our study, we ourselves have not performed prophylactic lateral neck dissection for PMC without US-detectable metastasis, because we now have evidence that dissection is not necessary in such cases. …