General Surgery Resident Salem Noureldine Helped Develop Central Neck Dissection Guidelines

May 16, 2017

Salem Noureldine, M.D., a first-year resident in the Department of General Surgery at the George Washington University School of Medicine and Health Sciences, was a member of the team that developed a consensus statement addressing the surgical guidelines for managing regional metastases in thyroid cancer patients for the American Head and Neck Society (AHNS), the largest surgical organization in the U.S. focused on thyroid cancer treatment. The statement, titled “Indications and Extent of Central Neck Dissection for Papillary Thyroid Cancer: An American Head and Neck Society Consensus Statement,” was recently published in the Journal of the Sciences and Specialties of the Head and Neck.

“Although lymph node metastases from thyroid cancer are frequently seen, specific and detailed surgical guidelines devoted to their management do not currently exist,” Noureldine explained. “We believe that this consensus statement provides evidence-based guidelines. It’s intended to offer a more surgically explicit discussion about the indications and extent of dissection in this patient population while balancing the surgical risks and oncological outcomes from the perspective of the AHNS.”

Central neck dissection is a risky operation, as the thyroid is located within lymphatic tissue of the neck, nested among a network of vital vessels and nerves. It is also cosmetically sensitive as patients are left with scars on their necks. These guidelines outline when it is appropriate to perform a dissection, and reduce the unnecessary variations in the management of thyroid cancer patients in order to provide optimal care.

Thyroid cancer has become one of the fastest growing cancers over the last few years. Each year, a person runs a one percent risk of developing a thyroid nodule, and 20 percent of those patients have the potential of developing cancer. It is projected that thyroid cancer will be the third most common cancer in women in 2019.

Noureldine, who is working towards a career as an endocrine surgeon, found himself on the team after joining the AHNS as a resident member in 2015 and having worked with members of the society’s endocrine committee prior to his residency. “I was fortunate to have been picked by the committee and allowed to participate … I feel really lucky,” he said. As part of the team, Noureldine was tasked with reviewing the literature to support the guidelines the team laid out and the specific goals of the consensus statement. He also participated in outline development and helped to organize all of the authors’ and reviewers’ comments in the draft sent to the AHNS to review and endorse.

To read “Indications and Extent of Central Neck Dissection for Papillary Thyroid Cancer: An American Head and Neck Society Consensus Statement,” please visit