The need of prophylactic central lymph node dissection is controversial in terms of postoperative thyroglobulin follow-up of patients with cN0 papillary thyroid cancer

Korkmaz, Mehmet; Öcal, Bülent; Saylam, Güleser; Çakal, Erman; Bayır, Ömer; Tutal, Esra; Tatar, Emel Çadallı

doi:10.1007/s00423-017-1556-y

Cited by 11 publications

(15 citation statements)

References 21 publications

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“…A total of 3916 publications were obtained from PubMed and 10 from hand searches. After 40 inappropriate articles were excluded, 15 studies ( 7 , 9 – 12 , 14 – 23 ) were eligible and incorporated into our study ( Figure 1 ). The basic characteristics of the included studies are shown in Table 1 .…”

Section: Resultsmentioning

confidence: 99%

“…Permanent recurrent laryngeal nerve injury was reported in five studies ( 7 , 12 , 18 , 19 , 23 ). There was no significant difference between the TT with PCND group and the TT alone group (OR 1.24, 95% CI 0.56-2.74, P = 0.587).…”

Section: Resultsmentioning

confidence: 99%

“…Nine included studies ( 7 , 9 , 12 , 14 , 19 – 23 ) reported transient hypoparathyroidism. The incidence of transient hypoparathyroidism in the TT with PCND group was higher than that in the TT alone group (OR 2.14, 95% CI 1.34-3.42, I 2 = 71.9%, P = 0.001).…”

Section: Resultsmentioning

confidence: 99%

“…Nine studies ( 7 , 9 , 10 , 12 , 18 – 20 , 22 , 23 ) reported permanent hypoparathyroidism. The incidence of permanent hypoparathyroidism was not significantly statistic difference in the two groups (OR 1.18, 95% CI 0.53-2.64, I 2 = 41.8%, P = 0.111).…”

Section: Resultsmentioning

confidence: 99%

“…Another advantage of TT with PCND seems to be the reduction in postoperative triglyceride levels ( 34 ). In Korkmaz MH’s study, median postoperative triglyceride levels were higher in the TT alone group ( 23 ), which sometimes led to unnecessary testing, increased use of radioiodine therapy, and reoperations ( 2 ).…”

Section: Discussionmentioning

confidence: 99%

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The effectiveness and safety of prophylactic central neck dissection in clinically node-negative papillary thyroid carcinoma patients: A meta-analysis

et al. 2023

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ObjectiveThis meta-analysis was performed to evaluate the effectiveness and safety of prophylactic central neck dissection (PCND) in patients with clinically node-negative (cN0) papillary thyroid carcinoma.Materials and methodsA meta-analysis of the literature was performed using the key words “papillary thyroid carcinomas” and “lymph node ecisions” for searches of electronic databases. Complications such as transient hypocalcemia, permanent hypocalcemia, transient and permanent hypoparathyroidism, transient and permanent vocal cord paralysis, transient recurrent and permanent recurrent laryngeal nerve injury, and local recurrence were pooled by meta-analysis. Stata17.0 was used to carry out the meta-analysis.ResultsData were extracted from 15 studies. In the present review, the group of patients who had total thyroidectomy (TT) with PCND had a lower local recurrence than the group with TT alone (OR 0.22, 95% CI 0.10-0.45, P = 0.000), whereas the incidence of permanent hypocalcemia (OR 4.24, 95% CI 1.05-17.22, P = 0.043) and transient hypoparathyroidism (OR 2.14, 95% CI 1.34-3.42, P =0.001) were higher. No significant differences were recorded in the incidence of other complications: transient hypocalcemia (OR 2.24, 95% CI 0.77-6.51, P = 0.138), permanent hypoparathyroidism (OR 1.70, 95% CI 0.89-3.27, P = 0.111), transient vocal cord paralysis (OR 1.48, 95% CI 0.78-2.83, P = 0.231), permanent vocal cord paralysis (OR 1.44, 95% CI 0.53-3.94, P = 0.477), transient recurrent laryngeal nerve injury (OR 1.47, 95% CI 0.93-2.32, P = 0.102) and permanent recurrent laryngeal nerve injury (OR 1.24, 95% CI 0.56-2.74, P = 0.587) between the two groups.ConclusionCompared with TT alone, TT with PCND was more effective in reducing local recurrence without increasing the risk of recurrent laryngeal nerve, thyroid and vocal cord, except for hypocalcemia and transient hypoparathyroidism. Therefore, we believe that TT with PCND should be recommended for patients with cN0 PTC.Systematic review registrationhttps://www.crd.york.ac.uk/prospero/, identifier CRD4202 2355078.

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