Total thyroidectomy alone versus ipsilateral versus bilateral prophylactic central neck dissection in clinically node-negative differentiated thyroid carcinoma. A retrospective multicenter study

2017 ◽  
Vol 43 (1) ◽  
pp. 126-132 ◽  
Author(s):  
P.G. Calò ◽  
G. Conzo ◽  
M. Raffaelli ◽  
F. Medas ◽  
C. Gambardella ◽  
...  
Keyword(s):  
Thyroid Carcinoma ◽  
Total Thyroidectomy ◽  
Neck Dissection ◽  
Multicenter Study ◽  
Differentiated Thyroid Carcinoma ◽  
Central Neck Dissection ◽  
Central Neck ◽  
Node Negative ◽  
Prophylactic Central Neck Dissection ◽  
Retrospective Multicenter Study

scholarly journals The Role of Prophylactic Central Neck Dissection in Differentiated Thyroid Carcinoma: Issues and Controversies

2011 ◽  
Vol 2011 ◽  
pp. 1-12 ◽  
Author(s):  
Kai-Pun Wong ◽  
Brian Hung-Hin Lang
Keyword(s):  
Thyroid Carcinoma ◽  
Total Thyroidectomy ◽  
Neck Dissection ◽  
Differentiated Thyroid Carcinoma ◽  
Central Neck Dissection ◽  
American Thyroid Association ◽  
Central Neck ◽  
Surgical Morbidity ◽  
Prophylactic Central Neck Dissection ◽  
Risk Patients

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.

Prophylactic Central Neck Dissection for Clinically Node‐Negative Papillary Thyroid Carcinoma

2021 ◽  
Author(s):  
Khaled M. Alsubaie ◽  
Hemail M. Alsubaie ◽  
Faisal R. Alzahrani ◽  
Mohammad A. Alessa ◽  
Sherif K. Abdulmonem ◽  
...  
Keyword(s):  
Papillary Thyroid Carcinoma ◽  
Thyroid Carcinoma ◽  
Neck Dissection ◽  
Central Neck Dissection ◽  
Central Neck ◽  
Papillary Thyroid ◽  
Node Negative ◽  
Prophylactic Central Neck Dissection

scholarly journals Morbidity Outcomes of Prophylactic Central Neck Dissection with Total Thyroidectomy versus Total Thyroidectomy Alone in Patients with Node Negative Papillary Thyroid Cancer: A Meta-Analysis of Observational Studies

2019 ◽  
Vol 34 (1) ◽  
pp. 6-13
Author(s):  
Christen-Zen I. Sison ◽  
Adrian F. Fernando ◽  
Therese Monique D.G. Gutierrez
Keyword(s):  
Total Thyroidectomy ◽  
Neck Dissection ◽  
Vocal Cord ◽  
Vocal Cord Paralysis ◽  
Meta Analysis ◽  
Central Neck Dissection ◽  
Central Neck ◽  
Papillary Thyroid ◽  
Node Negative ◽  
Prophylactic Central Neck Dissection

Objective: The primary objective of this meta-analysis is to compare locoregional recurrence, vocal cord paralysis, and permanent hypoparathyroidism in patients with thyroid papillary carcinoma without neck node metastases, after total thyroidectomy with and without prophylactic central neck dissection. Methods: Two independent reviewers performed a detailed literature search of MEDLINE (PubMed), HERDIN and Cochrane Library electronic databases to assess research studies until 2018 for inclusion. The primary endpoints of locoregional recurrence, permanent hypoparathyroidism, and vocal cord paralysis were included in the assessment.           Design:           Meta-Analysis of Retrospective Cohort Studies           Setting:          University Hospitals and Tertiary Referral Centers           Participants:            Patients with node-negative papillary thyroid cancer who underwent either total thyroidectomy alone or total thyroidectomy with prophylactic central neck dissection (either unilateral or bilateral). Results: This meta-analysis showed that there is a significantly increased risk for locoregional recurrence in the total thyroidectomy alone group (1.96% TT with pCND VS 2.60% TT, RR=0.62, 95% Cl=0.40-0.95, p=.03), permanent hypoparathyroidism in the total thyroidectomy with prophylactic central neck dissection group (5.72% TT with pCND vs 3.34% TT, RR=2.19, 95% Cl=1.62-2.98, p=.00001) and no significant difference for vocal cord paralysis between the 2 groups (RR=1.56, 95% Cl=0.86-2.84, p=.14). Conclusion: This meta-analysis revealed that performing pCND in patients with node-negative PTC increases the risk of morbidity for hypoparathyroidism but not for vocal cord paralysis. More importantly, the incidence of recurrence is decreased in the pCND group, which may have implications on the overall survival of patients. The benefit of performing pCND may outweigh the risk but the role of prophylactic CND in the treatment of patients with PTC with clinically negative lymph nodes is still debatable in terms of overall survival.   Keywords:  thyroidectomy, complications; neck dissection; papillary thyroid carcinoma; lymph node dissection; recurrence; vocal cord paralysis; hypoparathyroidism

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