**Abstract**

Lymph node metastasis is common in differentiated thyroid cancers. Therapeutic neck dissection removes macroscopic nodal metastasis, reduces local recurrence, and facilitates cancer surveillance. On the other hand, microscopic nodal metastasis is also increasingly recognized as a potential cause of persistent disease or early recurrences. Prophylactic neck dissection, by removing microscopic nodal metastasis, has been proposed to reduce recurrence and prevent future reoperation. When cancer recurs, regional nodal recurrence is most common, and the management should be individualized. We hereby present a narrative review on the management of nodal metastasis in differentiated thyroid cancers.

**Keywords:** differentiated thyroid cancer, nodal metastasis, neck dissection, therapeutic, prophylactic, recurrent nodal disease
