title: Impact of prophylactic central neck dissection on oncologic outcomes of papillary thyroid carcinoma: a review.
abstract: Prophylactic neck dissection (PND) for papillary thyroid carcinoma (PTC) is controversial. Our aim was to assess current levels of evidence (LE) according to the Oxford Centre for Evidence-based Medicine ( http://www.cebm.net/?O=1025 ) regarding the oncologic benefits of PND. Data were analyzed via MEDLINE keywords: PTC, differentiated thyroid carcinoma, PND, central lymph node metastases, central compartment, recurrence-free survival. There was conflicting evidence regarding the rate of reoperation for recurrence, with some studies showing a lower rate after PND with increased recurrence-free survival and a higher rate of undetectable pre- and post-ablation thyroglobulin levels (LE 4), whereas other studies did not show a difference (LE 4). Only one study (LE 4) showed improved disease-specific survival with PND. PND may improve recurrence-free survival, although this is supported by only a low LE. Current recommendations can only be based on low-level evidence.
authors.affiliation: Thyroid Surgery Unit, Department of Head and Neck Oncology, Institut Gustave Roussy, Paris-Sud University, Villejuif, France.
authors.forename: Elisabeth
authors.initials: E
authors.lastname: Mamelle
authors.forename: Isabelle
authors.initials: I
authors.lastname: Borget
authors.forename: Sophie
authors.initials: S
authors.lastname: Leboulleux
authors.forename: Haïtham
authors.initials: H
authors.lastname: Mirghani
authors.forename: Carlos
authors.initials: C
authors.lastname: Suárez
authors.forename: Phillip K
authors.initials: PK
authors.lastname: Pellitteri
authors.forename: Ashok R
authors.initials: AR
authors.lastname: Shaha
authors.forename: Marc
authors.initials: M
authors.lastname: Hamoir
authors.forename: K Thomas
authors.initials: KT
authors.lastname: Robbins
authors.forename: Avi
authors.initials: A
authors.lastname: Khafif
authors.forename: Juan P
authors.initials: JP
authors.lastname: Rodrigo
authors.forename: Carl E
authors.initials: CE
authors.lastname: Silver
authors.forename: Alessandra
authors.initials: A
authors.lastname: Rinaldo
authors.forename: Alfio
authors.initials: A
authors.lastname: Ferlito
authors.forename: Dana M
authors.initials: DM
authors.lastname: Hartl
mesh_terms: D002277:Carcinoma / Q000473:pathology / Q000601:surgery; D002291:Carcinoma, Papillary / Q000473:pathology / Q000601:surgery; D006801:Humans; D008207:Lymphatic Metastasis; D037981:Neck Dissection / Q000379:methods*; D009364:Neoplasm Recurrence, Local / Q000517:prevention & control / Q000601:surgery; D017063:Outcome Assessment, Health Care; D065286:Prophylactic Surgical Procedures / Q000379:methods; D012086:Reoperation; D000077273:Thyroid Cancer, Papillary; D013964:Thyroid Neoplasms / Q000473:pathology / Q000601:surgery; D013965:Thyroidectomy / Q000379:methods*