Is Performance of Routine Central Compartment Neck Dissection in cN0 Papillary Thyroid Cancers Really Useful? 10-Year Prospective Observational Study

Background: While papillary thyroid carcinoma (PTC) is associated with high occult central neck metastasis (CNM) rates, prophylactic central neck dissection (pCND) is controversial. This meta-analysis aims to look at the occult CNM rate according to tumor size. Methods: A literature search was conducted in PubMed from inception to April 2023. Inclusion criteria were primary studies that determined occult CNM rates in cN0 PTC by tumor size. Heterogeneity, influential case diagnostics, and proportion data were evaluated with Cochran’s Q-test, Baujat plots and Forest plots, respectively. Results: Fifty-two studies were included in this meta-analysis. The findings demonstrated an occult CNM rate of 30.3% for tumors ≤ 5 mm, 32.7% for tumors ≤ 1 cm, 46.0% for tumors between 1 and 2 cm, 43.1% for tumors between 2 and 4 cm, and 61.2% for tumors > 4 cm. The heterogeneity of each study group was high, though no publication bias was noted. While there was a trend towards increased occult CNM rates with larger tumors, comparisons between different size cutoffs varied in significance. Conclusion: This comprehensive review affirms that occult CNM is high and that an ipsilateral pCND can be justified in all PTC patients for accurate differentiation between Stage I and Stage II disease and its clinical implications.

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Chapter 5: Surgery for Neck in Well-differentiated Thyroid Cancers

Vaidya,

Sarin

2024

Journal of Head &Amp; Neck Physicians and Surgeons

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Thyroid cancers frequently metastasize to neck nodes. However, most of these are occult micrometastases with no impact on survival, while only a small percentage have clinically apparent neck nodes. The impact of nodal metastases on overall survival is very low, as compared to other head-neck sites and pathologies. Hence the surgical management of neck nodes has to be balanced with the likely morbidity of these procedures. This narrative review deals with the management of neck nodal metastasis of well differentiated thyroid cancers.

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Is Performance of Routine Central Compartment Neck Dissection in cN0 Papillary Thyroid Cancers Really Useful? 10-Year Prospective Observational Study

Cited by 3 publications

References 16 publications

Outcome of Total Thyroidectomy Versus Total Thyroidectomy + Prophylactic Central Compartment Lymph Node Dissection in Intrathyroidal Papillary Thyroid Carcinoma: A Propensity Score-Matched Analysis

Outcome of Total Thyroidectomy Versus Total Thyroidectomy + Prophylactic Central Compartment Lymph Node Dissection in Intrathyroidal Papillary Thyroid Carcinoma: A Propensity Score-Matched Analysis

Prevalence of Occult Central Lymph Node Metastasis by Tumor Size in Papillary Thyroid Carcinoma: A Systematic Review and Meta-Analysis

Chapter 5: Surgery for Neck in Well-differentiated Thyroid Cancers

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