title: The Effect of Prophylactic Central Neck Dissection on Locoregional Recurrence in Papillary Thyroid Cancer After Total Thyroidectomy: A Systematic Review and Meta-Analysis : pCND for the Locoregional Recurrence of Papillary Thyroid Cancer.
abstract: BACKGROUND
  The use of prophylactic central neck dissection (pCND) for papillary thyroid cancer (PTC) without clinical evidence of nodal metastasis (cN0) remains controversial. This study was designed to examine whether pCND for PTC affected locoregional recurrence (LRR).
  
  
  METHODS
  A systematic review was performed to compare the LRR between patients with PTC who underwent total thyroidectomy (TT) and pCND and those who underwent TT alone. The primary outcome was LRR. Other outcomes, including postoperative radioiodine (RAI) ablation and surgically related complications, were evaluated. A meta-analysis was performed using the random-effects model.
  
  
  RESULTS
  We included 17 studies, which comprised 4437 patients. Patients in the TT+pCND group had a significantly reduced risk of LRR (risk ratio [RR] = 0.66; 95% confidence interval [CI]: 0.49-0.90; P = 0.008). The LRR in the central neck compartment (RR = 0.35; 95% CI 0.18-0.68; P = 0.002) was significantly lower in the TT+pCND group, whereas the LRR in the lateral neck compartment was similar between the two groups. Compared with the TT alone group, patients in the TT+pCND group tended to receive higher RAI (74.6% vs. 59.9%) and experience temporary hypocalcemia (odds ratio [OR] = 2.37; 95% CI 1.89-2.96; P < 0.00001), permanent hypocalcemia (OR = 1.93; 95% CI 1.05-3.57; P = 0.03), and increased overall morbidity (OR = 2.56; 95% CI 1.75-3.74; P < 0.00001).
  
  
  CONCLUSIONS
  This meta-analysis suggested that although pCND reduced the LRR in PTC-specifically in the central neck compartment-it was accompanied by an increased rate of postoperative hypocalcemia. However, the evidence is limited and randomized, controlled trials are needed to clarify this role further.
authors.affiliation: Department of General Surgery, Peking Union Medical College Hospital, Chinese Academy of Medical Science & Peking Union Medical College, Beijing, China.
authors.forename: Wenjing
authors.initials: W
authors.lastname: Zhao
authors.affiliation: Department of General Surgery, Peking Union Medical College Hospital, Chinese Academy of Medical Science & Peking Union Medical College, Beijing, China.
authors.forename: Lei
authors.initials: L
authors.lastname: You
authors.affiliation: Department of General Surgery, Peking Union Medical College Hospital, Chinese Academy of Medical Science & Peking Union Medical College, Beijing, China.
authors.forename: Xianming
authors.initials: X
authors.lastname: Hou
authors.affiliation: Department of General Surgery, Peking Union Medical College Hospital, Chinese Academy of Medical Science & Peking Union Medical College, Beijing, China.
authors.forename: Shaobo
authors.initials: S
authors.lastname: Chen
authors.affiliation: Department of General Surgery, Peking Union Medical College Hospital, Chinese Academy of Medical Science & Peking Union Medical College, Beijing, China.
authors.forename: Xiaoxia
authors.initials: X
authors.lastname: Ren
authors.affiliation: Department of General Surgery, Peking Union Medical College Hospital, Chinese Academy of Medical Science & Peking Union Medical College, Beijing, China. pumchchenge@163.com.
authors.forename: Ge
authors.initials: G
authors.lastname: Chen
authors.affiliation: Department of General Surgery, Peking Union Medical College Hospital, Chinese Academy of Medical Science & Peking Union Medical College, Beijing, China. zhao8028@263.net.
authors.forename: Yupei
authors.initials: Y
authors.lastname: Zhao
mesh_terms: D002291:Carcinoma, Papillary / Q000473:pathology / Q000601:surgery*; D006801:Humans; D037981:Neck Dissection; D009364:Neoplasm Recurrence, Local / Q000473:pathology / Q000601:surgery*; D011379:Prognosis; D013964:Thyroid Neoplasms / Q000473:pathology / Q000601:surgery*; D013965:Thyroidectomy