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Published on: September 15, 2023
Prophylactic Central Lymph Node Dissection Versus Thyroidectomy Alone in Clinically Node-Negative Thyroid Cancer: A
Xianfeng Zhou1, Junhong Jiang2
1Department of Thyroid and Breast Surgery, Chengdu First People's Hospital/Chengdu Integrated TCM& Western Medicine Hospital, Chengdu, China.
Ear, Nose, & Throat Journal
|May 14, 2026
Summary
Prophylactic central neck dissection in node-negative thyroid cancer improves staging accuracy but does not reduce recurrence or improve survival. Its use should be selective due to increased surgical risks.
Area of Science:
- Oncology
- Surgical Oncology
- Evidence-Based Medicine
Background:
- The clinical utility of prophylactic central neck dissection (pCND) in clinically node-negative (cN0) thyroid cancer is debated.
- pCND may improve staging and reduce recurrence but carries risks like hypoparathyroidism and nerve injury.
Purpose of the Study:
- To evaluate the benefits and risks of pCND in cN0 thyroid cancer patients.
- To provide robust evidence through a meta-analysis of randomized controlled trials (RCTs).
Main Methods:
- Systematic review and meta-analysis of RCTs following PRISMA guidelines.
- Searches of major databases (PubMed, EMBASE, Web of Science, Cochrane Library) up to September 2025.
- Independent data extraction, bias assessment, and synthesis.
Main Results:
- Seven RCTs with 1,484 patients were analyzed.
- pCND significantly increased lymph node metastasis detection (OR 7.43, p<0.001).
- No clear reduction in recurrence/persistence (OR 1.09, p=0.80) or survival (OR 1.45, p=0.82) was observed. A trend towards increased morbidity (OR 1.55, p=0.11), especially hypoparathyroidism, was noted.
Conclusions:
- pCND in cN0 thyroid cancer enhances pathological staging but lacks demonstrated therapeutic benefit for recurrence or survival.
- The findings suggest pCND has a primarily prognostic role, not routinely indicated.
- Selective application based on patient factors and surgical expertise is recommended.
