Central Neck Dissection In Differentiated Thyroid Carcinoma:A Meta-Analysis

Objective/Hypothesis:The role of central neck dissection (CND) remains controversial in differentiated thyroid cancer (DTC).Study Design:Systematic review and meta-analysis.Methods:Electronic databases(Medline, ScienceDirect-Elsevier, Springerlink, and Embase; China Biological Medicine Database(CBM), Chinese National Knowledge Infrastructure(CNKI), Wanfang Database from January1990to April2012were searched by two individuals to identify all clinical trials comparing different extents of lymphadenectomy with TT for DTC. A search strategy comprising disease-specific search terms (e.g differentiated thyroid carcinoma), management-specific terms (e.g, total thyroidectomy, lymph node dissection) and terms related to procedures of lymphnode dissection (e.g, central node dissection, ipsilateral, and bilateral) was used. All abstracts and citations were reviewed. The related articles function was used to broaden the search, and references of the articles acquired were also searched. A systematic review and meta-analysis focusing on surgical morbidities and locoregional recurrence after total thyroidectomy (TT) with CND versus TT alone was performed.Results:Seventeen trials were analyzed. There was no increased risk of recurrent laryngeal nerve (RLN) injury (temporaryor permanent), permanent hypocalcemia, when CND was performed in addition to TT. locoregional recurrence was slightly higher after TT than after TT with CND, but this difference was not statistically significant. Postoperative temporary hypocalcemia was more common after TT with CND than after TT alone. Conclusions:TT alone results in less surgical morbidity in the immediate postoperative period and an identical locoregional recurrence rate compared with TT plus CND.