[Current status and controversies surrounding prophylactic central neck lymph node dissection in clinically lymph...

Central neck compartment metastases are most commonly found in papillary thyroid cancer(PTC) patients. Central neck dissection (CND), encompassing lymph node levels Ⅵ and Ⅶ, remains controversial when performed prophylactically CND (pCND) in clinically node-negative (cN0) PTC patients. Current guidelines, consensus statements, and literatures lack a unified, objective criterion for determining cN0 status. The reasons for the controversy surrounding pCND lie in the varying oncological benefits and complication rates of pCND reported in different studies for cN0 PTC patients, as well as the inconsistent research conclusions drawn by scholars from China and the West. Currently, there is insufficient evidence from large-sample, long-term follow-up randomized controlled trials to support the oncologic benefits of pCND. Therefore, the application of non-long-term follow-up study results regarding pCND in cN0 PTC should be interpreted and approached with caution. Furthermore, there is no established quality control indicators for CND. Anatomic landmark-guided standardized CND is crucial for ensuring the quality control of pCND.