Table of Contents
Advances in Endocrinology
Volume 2014, Article ID 714291, 6 pages
Review Article

Measuring Quality in Thyroid Cancer Surgery

Section of Endocrine Surgery, Department of Surgery, University of Wisconsin, 600 Highland Avenue, K4/704 CSC, Madison, WI 53792, USA

Received 16 February 2014; Accepted 8 May 2014; Published 22 May 2014

Academic Editor: Pere Berbel

Copyright © 2014 David F. Schneider and Rebecca S. Sippel. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.


Many of the surgical quality measures currently in use are not disease specific. For thyroid cancer, mortality and even recurrence are difficult to measure since mortality is rare and recurrence can take decades to occur. Therefore, there is a critical need for quality indicators in thyroid cancer surgery that are easily measured and disease specific. Here we will review recent research on two potential quality indicators in thyroid cancer surgery. The uptake percentage on postoperative radioactive iodine scans indicates the completeness of resection. Another measure, the lymph node ratio, is the proportion of metastatic nodes to the total number of nodes dissected. This serves as a more global measure of quality since it indicates not only the completeness of lymph node dissection but also the preoperative lymph node evaluation and decision-making. Together, these two quality measures offer a more accurate, disease-specific oncologic indicator of quality that can help guide quality assurance and improvement.