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Related Experiment Video

Updated: Oct 15, 2025

Transoral Robotic Total Thyroidectomy and Bilateral Central Regional Lymph Node Dissection for Papillary Thyroid Carcinoma
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Prophylactic Central Neck Dissection for Clinically Node-Negative Papillary Thyroid Carcinoma.

Khaled M Alsubaie1, Hemail M Alsubaie2, Faisal R Alzahrani3,4

  • 1Department of Surgery, Alhada Armed Forces Hospital, Taif, Saudi Arabia.

The Laryngoscope
|October 28, 2021
PubMed
Summary

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For clinically node-negative papillary thyroid cancer, adding prophylactic central neck dissection to total thyroidectomy showed no significant difference in recurrence or complications. Decisions should weigh oncological benefits against potential adverse events.

Area of Science:

  • Endocrinology
  • Surgical Oncology
  • Clinical Research

Background:

  • Papillary thyroid cancer (PTC) management involves balancing oncological control with surgical morbidity.
  • The role of prophylactic central neck dissection (pCND) in clinically node-negative (cN0) PTC remains debated.
  • Total thyroidectomy (TT) is a standard treatment for PTC.

Purpose of the Study:

  • To systematically review and meta-analyze randomized controlled trials (RCTs) comparing TT plus pCND versus TT alone in cN0 PTC patients.
  • To evaluate the oncological benefits and postsurgical complications of these two surgical approaches.
  • To provide evidence-based guidance for surgical decision-making in cN0 PTC.

Main Methods:

  • Systematic review and meta-analysis of RCTs sourced from five databases up to September 4, 2021.
Keywords:
Prophylactic central neck dissectionmeta-analysispapillary thyroid cancerrandomized controlled trialstotal thyroidectomy

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  • Risk of bias assessment for included studies.
  • Pooling of dichotomous outcomes using risk ratio (RR) with 95% confidence intervals (CI).

    • Main Results:

    • Five RCTs with low risk of bias, involving 795 patients (410 TT+pCND, 385 TT alone), were included.
    • No significant difference in structural loco-regional recurrence rates between TT+pCND and TT alone (RR=0.49, P=0.14).
    • No significant differences in rates of hypoparathyroidism (RR=1.48, P=0.27), recurrent laryngeal nerve injury (RR=1.34, P=0.48), or bleeding (RR=1.75, P=0.44).

    Conclusions:

    • In cN0 PTC patients, TT plus pCND offers no significant advantage over TT alone regarding loco-regional recurrence or postsurgical complications.
    • Surgical strategy adaptation should consider both oncological outcomes and the risk of adverse events.
    • The routine use of pCND in cN0 PTC warrants careful consideration.