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Routine central neck dissection in differentiated thyroid carcinoma: a systematic review and meta-analysis
Cheng-Xiang Shan1, Wei Zhang, Dao-Zhen Jiang
1Department of General surgery, Chang Zheng Hospital affiliated to Second Military Medical University, Shanghai, People's Republic of China.
The Laryngoscope
|February 2, 2012
Summary
Central neck dissection (CND) in differentiated thyroid cancer (DTC) surgery does not increase recurrence risk but may raise temporary hypocalcemia. Total thyroidectomy (TT) alone offers less immediate surgical morbidity.
Area of Science:
- Endocrinology
- Surgical Oncology
- Head and Neck Surgery
Background:
- The necessity of central neck dissection (CND) in differentiated thyroid cancer (DTC) management is debated.
- Understanding the impact of CND on surgical outcomes and recurrence is crucial for treatment guidelines.
Purpose of the Study:
- To systematically review and meta-analyze surgical morbidities and locoregional recurrence rates.
- To compare total thyroidectomy (TT) with CND versus TT alone in DTC patients.
Main Methods:
- Systematic review and meta-analysis of sixteen relevant trials.
- Focused analysis on recurrent laryngeal nerve (RLN) injury, hypocalcemia, and locoregional recurrence.
Main Results:
- No significant increase in temporary or permanent RLN injury was observed with CND.
- Permanent hypocalcemia and locoregional recurrence rates were similar between TT with CND and TT alone.
- Temporary hypocalcemia was more frequent postoperatively in the TT with CND group.
Conclusions:
- Total thyroidectomy (TT) alone is associated with reduced immediate postoperative surgical morbidity compared to TT plus CND.
- The locoregional recurrence rate is identical between TT alone and TT plus CND for differentiated thyroid cancer.
