Routine central neck dissection in differentiated thyroid carcinoma: A systematic review and meta-analysis

Prophylactic central neck dissection (pCND) in differentiated thyroid carcinoma (DTC) is one of the most controversial surgical subjects in recent times. To date, there is little evidence to support the practice of pCND in patients with DTC undergoing total thyroidectomy. Although the recently revised American Thyroid Association (ATA) guideline has clarified many inconsistencies regarding pCND and has recommended pCND in “high-risk” patients, many issues and controversies surrounding the subject of pCND in DTC remain. The recent literature has revealed an insignificant trend toward lower recurrence rate in patients with DTC who undergo total thyroidectomy and pCND than those who undergo total thyroidectomy alone. However, this was subjected to biases, and there are concerns whether pCND should be performed by all surgeons who manage DTC because of increased surgical morbodity. Performing a unilateral pCND may be better than a bilateral pCND given its lower surgical morbidity. Further studies in this controversial subject are much needed.

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Evaluating the effectiveness of prophylactic central neck dissection with total thyroidectomy for cN0 papillary thyroid carcinoma: An updated meta-analysis

European Journal of Surgical Oncology ◽

10.1016/j.ejso.2017.07.008 ◽

2017 ◽

Vol 43 (11) ◽

pp. 1989-2000 ◽

Cited By ~ 25

Author(s):

Wan-jun Zhao ◽

Han Luo ◽

Yi-mei Zhou ◽

Wen-yu Dai ◽

Jing-qiang Zhu

Keyword(s):

Papillary Thyroid Carcinoma ◽

Thyroid Carcinoma ◽

Total Thyroidectomy ◽

Neck Dissection ◽

Meta Analysis ◽

Central Neck Dissection ◽

Central Neck ◽

Papillary Thyroid ◽

Prophylactic Central Neck Dissection

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Conceptual interpretation of analysing and reporting of results on systematic review and meta-analysis of optimal extent of lateral neck dissection for well-differentiated thyroid carcinoma with metastatic lateral neck lymph nodes

Oral Oncology ◽

10.1016/j.oraloncology.2018.12.031 ◽

2019 ◽

Vol 89 ◽

pp. 153-154 ◽

Cited By ~ 8

Author(s):

Rama Jayaraj ◽

Chellan Kumarasamy

Keyword(s):

Systematic Review ◽

Thyroid Carcinoma ◽

Lymph Nodes ◽

Neck Dissection ◽

Meta Analysis ◽

Differentiated Thyroid Carcinoma ◽

Lateral Neck ◽

Lateral Neck Dissection ◽

Well Differentiated ◽

Neck Lymph Nodes

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Optimal extent of lateral neck dissection for well-differentiated thyroid carcinoma with metastatic lateral neck lymph nodes: A systematic review and meta-analysis

Oral Oncology ◽

10.1016/j.oraloncology.2018.10.035 ◽

2018 ◽

Vol 87 ◽

pp. 117-125 ◽

Cited By ~ 7

Author(s):

Ho-Ryun Won ◽

Jae Won Chang ◽

Yea Eun Kang ◽

Jae Yoon Kang ◽

Bon Seok Koo

Keyword(s):

Systematic Review ◽

Thyroid Carcinoma ◽

Lymph Nodes ◽

Neck Dissection ◽

Meta Analysis ◽

Differentiated Thyroid Carcinoma ◽

Lateral Neck ◽

Lateral Neck Dissection ◽

Well Differentiated ◽

Neck Lymph Nodes

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Prophylactic Central Neck Dissection for cN1b Papillary Thyroid Carcinoma: A Systematic Review and Meta-Analysis

Frontiers in Oncology ◽

10.3389/fonc.2021.803986 ◽

2022 ◽

Vol 11 ◽

Author(s):

Xing-qiang Yan ◽

Zhen-zhen Zhang ◽

Wen-jie Yu ◽

Zhao-sheng Ma ◽

Min-long Chen ◽

...

Keyword(s):

Systematic Review ◽

Clinical Trials ◽

Papillary Thyroid Carcinoma ◽

Thyroid Carcinoma ◽

Meta Analysis ◽

Central Neck Dissection ◽

Central Neck ◽

Papillary Thyroid ◽

Prophylactic Central Neck Dissection ◽

Neck Recurrence

BackgroundThe value of prophylactic central neck dissection (PCND) for papillary thyroid carcinoma (PTC) with clinically evident lateral cervical lymph node metastases (cN1b) remains unclear. Therefore, a systematic review and meta-analysis was conducted to assess the efficacy and safety of PCND.MethodsA comprehensive systematic search was conducted on PubMed, Web of Science, Cochrane library and Embase databases up to September 2021 to identify eligible studies. Controlled clinical trials assessing therapeutic effects and safety of PCND for cN1b PTC patients were included. The risk of bias for each cohort study was assessed using the Newcastle-Ottawa Scale (NOS). The primary outcomes were indexes related to the locoregional recurrence (LRR) and surgical complications. Review Manager software V5.4.0 was used for statistical analysis. A fixed effects model was adopted for the data without heterogeneity, otherwise a random effects model was used.ResultsWe included 4 retrospective cohort studies, which comprised 483 PTC patients. There was no statistically significant difference in the central neck recurrence (CNR) (10.2% vs. 3.8%, relative risk (RR) = 1.82; 95%CI 0.90–3.67; P = 0.09), lateral neck recurrence (LNR) (5.1% vs. 7.7%, RR = 0.47; 95% CI 0.13–1.74; P = 0.26), and overall recurrence (OR) (18.9% vs. 16.9%, RR = 0.77; 95%CI 0.34–1.76; P = 0.54), between LND + PCND group and LND group. Simultaneously, PCND increased the risk of permanent hypoparathyroidism (11.4% vs. 4.5%, RR = 2.70, 95%CI 1.05–6.94; P = 0.04) and overall complications (17.0% vs. 5.3%, RR = 3.28; 95%CI 1.37–7.86; P = 0.008).ConclusionsThis meta-analysis showed that PCND did not have any advantage in preventing LRR for cN1b PTC. Meanwhile, PCND may result in the increased rate of surgical complications. However, the current evidence is limited and more clinical trials are still needed to further clarify the true role of PCND.Systematic Review Registrationhttps://www.crd.york.ac.uk/PROSPERO/, CRD42021281825.

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