title: The clinical prognosis of patients with cN0 papillary thyroid microcarcinoma by central neck dissection.
abstract: BACKGROUND
  Central lymph node metastasis of papillary thyroid microcarcinoma (PTMC) is common; however, prophylactic central lymph node dissection (CLND) is still controversial because of the possible increased morbidity. The purpose of this study is to determine the clinical outcome of patients with cN0 PTMC by central neck dissection.
  
  
  METHODS
  A retrospective cohort study was conducted on patients with PTMC without preoperative evidence of lymph node disease (cN0), and the outcomes were compared between patients undergoing total thyroidectomy (TT) alone (group A) and patients undergoing TT with CLND (group B).
  
  
  RESULTS
  In this study, 242 patients with cN0 PTMC were included. Group A had 108 patients and group B had 134 patients. During a follow-up of over 60 months, the long-term postoperative complications were equivalent between the two groups. In group B, the presence of involved central neck lymph nodes upstaged 16% of patients to stage III disease, which necessitated additional postoperative radioactive iodine treatment. More patients had recurrences in group A. The rate of reoperation in the central compartment was higher in group A than in group B (8.3% vs 2.2%, P < 0.01).
  
  
  CONCLUSIONS
  Prophylactic CLND does not increase long-term postoperative complications and reduces the risk of recurrence in the central compartment.
authors.affiliation: General Surgery Department, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences, No.1 Shuaifu Garden, Dongcheng District, 100730, Beijing, China. Liyangzhang25@hotmail.com.
authors.forename: Liyang
authors.initials: L
authors.lastname: Zhang
authors.affiliation: General Surgery Department, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences, No.1 Shuaifu Garden, Dongcheng District, 100730, Beijing, China. lzw1999@sohu.com.
authors.forename: Ziwen
authors.initials: Z
authors.lastname: Liu
authors.affiliation: General Surgery Department, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences, No.1 Shuaifu Garden, Dongcheng District, 100730, Beijing, China. liuyuewu615@vip.sina.com.
authors.forename: Yuewu
authors.initials: Y
authors.lastname: Liu
authors.affiliation: General Surgery Department, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences, No.1 Shuaifu Garden, Dongcheng District, 100730, Beijing, China. gaoweisheng@pumch.cn.
authors.forename: Weisheng
authors.initials: W
authors.lastname: Gao
authors.affiliation: General Surgery Department, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences, No.1 Shuaifu Garden, Dongcheng District, 100730, Beijing, China. zhengchaoji@gmail.com.
authors.forename: Chaoji
authors.initials: C
authors.lastname: Zheng
mesh_terms: D002291:Carcinoma, Papillary / Q000517:prevention & control / Q000556:secondary / Q000601:surgery*; D005260:Female; D006801:Humans; D008197:Lymph Node Excision; D008207:Lymphatic Metastasis / Q000517:prevention & control; D008297:Male; D008875:Middle Aged; D037981:Neck Dissection; D009364:Neoplasm Recurrence, Local / Q000517:prevention & control; D065286:Prophylactic Surgical Procedures; D012189:Retrospective Studies; D013964:Thyroid Neoplasms / Q000517:prevention & control / Q000556:secondary / Q000601:surgery*; D013965:Thyroidectomy