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Prophylactic Central Neck Dissection and Local Recurrence in Papillary Thyroid Cancer: A Meta-analysis

  • Endocrine Tumors
  • Published:
Annals of Surgical Oncology Aims and scope Submit manuscript

Abstract

Background

The effectiveness of prophylactic central neck dissection (pCND) in the treatment of patients with papillary thyroid carcinoma (PTC) to prevent local recurrence is controversial. We performed a meta-analysis to assess the effect of pCND on local recurrence in PTC.

Methods

Exhaustive search of online search engines identified five retrospective studies that compared the local recurrence rates of PTC in patients without clinically detectable nodal disease in patients undergoing thyroidectomy + pCND (group A) to those undergoing thyroidectomy alone (group B). A meta-analysis was performed by the fixed effects method. Recurrence was documented by imaging, thyroglobulin detection, or reoperation. Location of recurrence was identified in either the central or lateral neck compartment.

Results

A total of 1264 patients were included, 396 in group A and 868 in group B. Follow-up ranged from 6 months to 27 years. The overall recurrence rate was 2.02% in group A versus 3.92% in group B (odds ratio [OR] = 1.05, 95% confidence interval [95% CI] 0.48–2.31). The recurrence rate in the central neck compartment in group A was 1.86% compared to 1.68% in group B (OR = 1.31, 95% CI 0.44–3.91). The recurrence rate in the lateral neck compartment in group A was 3.73% compared to 3.79% in group B (OR = 1.21, 95% CI 0.52–2.75). There was no statistically significant difference in the OR in the local recurrence between the two groups.

Conclusions

This meta-analysis indicates that pCND does not greatly reduce local recurrence in thyroid cancer. However, the available studies have substantial limitations and a prospective multicenter study to determine the indications for pCND is warranted.

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Acknowledgment

We thank Jong-Lyel Roh, MD, PhD, for sending data and providing help. There was no commercial interest of any of the authors or external financial support for this study.

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Authors and Affiliations

  1. Department of Surgery, Weill Cornell Medical College, New York, NY, USA

    Tarek Zetoune MD, Xavier Keutgen MD, Daniel Buitrago MD, Hasan Aldailami, Thomas J. Fahey III MD & Rasa Zarnegar MD

  2. Department of Public Health, Weill Cornell Medical College, New York, NY, USA

    Huibo Shao MS & Madhu Mazumdar PhD

Authors
  1. Tarek Zetoune MD
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  2. Xavier Keutgen MD
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  3. Daniel Buitrago MD
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  4. Hasan Aldailami
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  5. Huibo Shao MS
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  6. Madhu Mazumdar PhD
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  7. Thomas J. Fahey III MD
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  8. Rasa Zarnegar MD
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Correspondence to Rasa Zarnegar MD.

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Zetoune, T., Keutgen, X., Buitrago, D. et al. Prophylactic Central Neck Dissection and Local Recurrence in Papillary Thyroid Cancer: A Meta-analysis. Ann Surg Oncol 17, 3287–3293 (2010). https://doi.org/10.1245/s10434-010-1137-6

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  • DOI: https://doi.org/10.1245/s10434-010-1137-6

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