title: [Meta-analysis of the clinical significance of thyroidectomy combined with central neck dissection in differentiated thyroid carcinoma at the first treatment].
abstract: OBJECTIVE
  To compare the differences in recurrence rates and surgical complications between thyroidectomy alone and thyroidectomy combined with central neck dissection as initial treatments to differentiated thyroid cancer and evaluate the clinic significance of central neck dissection for these patients.
  
  
  METHODS
  The literatures published in 1998-2013 were searched in Wanfang database, Chongqing VIP database, Chinese Biomedical Literature Database, China National Knowledge Infrastructure, Pubmed, Medline and Beijing Kangjian foreign medical journal full text service. According to the inclusion and deletion criteria, 30 articles were included. Of them 26 articles involved in complications, hypocalcemia and recurrent laryngeal nerve palsy as two major complications were involved in 26 articles and 24 articles respectively, and 26 articles involved in recurrence rate. RevMan5.0 software package was used to perform meta-analysis.
  
  
  RESULTS
  Total complication rate in experimental group (plus central neck dissection) was 13.08% higher than that in control group (thyroidectomy only), the odds ratio (OR) [95% confidence interval (95%CI)] was 2.32[2.02, 2.67], Z value was 11.80, P < 0.01. Hypocalcemia in the experimental group was 11.80% higher than that in control group, OR value [95%CI] was 2.58[2.21, 3.02], Z was 11.98, P < 0.01. The rates of recurrent laryngeal nerve paralysis were low in both experimental group (5.26%) and control group(3.95%), and OR value [95%CI] was 1.22 [0.94, 1.58], Z was 1.48, P = 0.14. Recurrence rate in experimental group was 2.23% lower than that in control group, OR value [95%CI] was 0.78 [0.63,0.97], Z was 2.35, P = 0.03.
  
  
  CONCLUSIONS
  Central compartment dissection as initial treatment to differentiated thyroid cancer may reduce the risk of recurrence, but increases the incidence of total complications and hypocalcemia, and has no significant effect on the rate of the recurrent laryngeal nerve paralysis.
authors.affiliation: Department of Head and Neck Surgery, Sichuan Cancer Hospital Cancer Institute, Chengdu 610041, China.
authors.forename: Ronghao
authors.initials: R
authors.lastname: Sun
authors.affiliation: Department of Head and Neck Surgery, Sichuan Cancer Hospital Cancer Institute, Chengdu 610041, China. Email: sclichao@qq.com.
authors.forename: Chao
authors.initials: C
authors.lastname: Li
authors.affiliation: Department of Head and Neck Surgery, Sichuan Cancer Hospital Cancer Institute, Chengdu 610041, China.
authors.forename: Jinchuan
authors.initials: J
authors.lastname: Fan
authors.affiliation: Department of Head and Neck Surgery, Sichuan Cancer Hospital Cancer Institute, Chengdu 610041, China.
authors.forename: Jifeng
authors.initials: J
authors.lastname: Liu
authors.affiliation: Department of Head and Neck Surgery, Sichuan Cancer Hospital Cancer Institute, Chengdu 610041, China.
authors.forename: Jianchao
authors.initials: J
authors.lastname: Chen
authors.affiliation: Department of Head and Neck Surgery, Sichuan Cancer Hospital Cancer Institute, Chengdu 610041, China.
authors.forename: Bing
authors.initials: B
authors.lastname: Zhang
mesh_terms: D006801:Humans; D037981:Neck Dissection; D009364:Neoplasm Recurrence, Local; D013964:Thyroid Neoplasms / Q000473:pathology* / Q000601:surgery*