Annals of Surgical Oncology

, Volume 20, Issue 11, pp 3477–3483 | Cite as

A Meta-analysis of the Effect of Prophylactic Central Compartment Neck Dissection on Locoregional Recurrence Rates in Patients with Papillary Thyroid Cancer

  • Tracy S. Wang
  • Kevin Cheung
  • Forough Farrokhyar
  • Sanziana A. Roman
  • Julie Ann Sosa
Endocrine Tumors

Abstract

Background

It is not known whether prophylactic central compartment neck dissection (pCCND) in conjunction with total thyroidectomy decreases rates of locoregional recurrence in patients with papillary thyroid cancer (PTC).

Methods

A meta-analysis was performed of reported recurrence rates of clinically node-negative PTC in patients treated with total thyroidectomy (TT) alone, or TT and pCCND. The primary outcome was locoregional recurrence of PTC.

Results

Eleven studies capturing 2,318 patients met the inclusion criteria. Overall, the recurrence rate for patients undergoing TT/pCCND was 3.8 % [95 % confidence interval (CI) 2.3–5.8]. In the six comparative studies, which included 1,740 patients, 995 patients undergoing TT and 745 patients undergoing TT/pCCND, the overall recurrence rate was 7.6:7.9 % in the TT group and 4.7 % in the TT/pCCND group. The relative risk of recurrence was 0.59 (95 % CI 0.33–1.07), favoring a lower recurrence rate in the TT/pCCND arm. The number of patients that would need to be treated (NNT) in order to prevent a single recurrence is 31. The relative risk for permanent hypocalcemia was 1.82 (95 % CI 0.51–6.5) and for permanent recurrent laryngeal nerve injury was 1.14 (95 % CI 0.46–2.83).

Conclusions

There was no difference in recurrence or long-term complication rates between patients undergoing TT or TT/pCCND. There was a trend toward lower recurrence rates in TT/pCCND patients, with a NNT of 31 patients. On the basis of these data, routine pCCND might be considered in the hands of high-volume surgeons treating patients with clinically node-negative PTC.

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Copyright information

© Society of Surgical Oncology 2013

Authors and Affiliations

  • Tracy S. Wang
    • 1
  • Kevin Cheung
    • 2
  • Forough Farrokhyar
    • 2
    • 3
  • Sanziana A. Roman
    • 4
  • Julie Ann Sosa
    • 4
  1. 1.Department of SurgeryMedical College of WisconsinMilwaukeeUSA
  2. 2.Department of SurgeryMcMaster UniversityHamiltonCanada
  3. 3.Department of Clinical Epidemiology and BiostatisticsMcMaster UniversityHamiltonCanada
  4. 4.Department of SurgeryDuke University School of MedicineDurhamUSA

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