title: A meta-analysis of the effect of prophylactic central compartment neck dissection on locoregional recurrence rates in patients with papillary thyroid cancer.
abstract: BACKGROUND
  It is not known whether prophylactic central compartment neck dissection (pCCND) in conjunction with total thyroidectomy decreases rates of locoregional recurrence in patients with papillary thyroid cancer (PTC).
  
  
  METHODS
  A meta-analysis was performed of reported recurrence rates of clinically node-negative PTC in patients treated with total thyroidectomy (TT) alone, or TT and pCCND. The primary outcome was locoregional recurrence of PTC.
  
  
  RESULTS
  Eleven studies capturing 2,318 patients met the inclusion criteria. Overall, the recurrence rate for patients undergoing TT/pCCND was 3.8 % [95 % confidence interval (CI) 2.3-5.8]. In the six comparative studies, which included 1,740 patients, 995 patients undergoing TT and 745 patients undergoing TT/pCCND, the overall recurrence rate was 7.6:7.9 % in the TT group and 4.7 % in the TT/pCCND group. The relative risk of recurrence was 0.59 (95 % CI 0.33-1.07), favoring a lower recurrence rate in the TT/pCCND arm. The number of patients that would need to be treated (NNT) in order to prevent a single recurrence is 31. The relative risk for permanent hypocalcemia was 1.82 (95 % CI 0.51-6.5) and for permanent recurrent laryngeal nerve injury was 1.14 (95 % CI 0.46-2.83).
  
  
  CONCLUSIONS
  There was no difference in recurrence or long-term complication rates between patients undergoing TT or TT/pCCND. There was a trend toward lower recurrence rates in TT/pCCND patients, with a NNT of 31 patients. On the basis of these data, routine pCCND might be considered in the hands of high-volume surgeons treating patients with clinically node-negative PTC.
authors.affiliation: Department of Surgery, Medical College of Wisconsin, Milwaukee, WI, USA. tswang@mcw.edu
authors.forename: Tracy S
authors.initials: TS
authors.lastname: Wang
authors.forename: Kevin
authors.initials: K
authors.lastname: Cheung
authors.forename: Forough
authors.initials: F
authors.lastname: Farrokhyar
authors.forename: Sanziana A
authors.initials: SA
authors.lastname: Roman
authors.forename: Julie Ann
authors.initials: JA
authors.lastname: Sosa
mesh_terms: D002277:Carcinoma / Q000150:complications* / Q000601:surgery; D002291:Carcinoma, Papillary; D006801:Humans; D008197:Lymph Node Excision / Q000009:adverse effects*; D009364:Neoplasm Recurrence, Local / Q000188:drug therapy / Q000473:pathology; D011183:Postoperative Complications; D011379:Prognosis; D061226:Recurrent Laryngeal Nerve Injuries / Q000175:diagnosis / Q000209:etiology*; D000077273:Thyroid Cancer, Papillary; D013964:Thyroid Neoplasms / Q000150:complications* / Q000601:surgery; D013965:Thyroidectomy / Q000009:adverse effects*