Prophylactic Central Neck Dissection Versus Traditional Total Thyroidectomy For Stage CN0 Papillary Thyroid Carcinoma: A Meta-analysis

Objective: To systematically evaluate the effectiveness and safety of prophylactic central neck dissection(PCND)for stage cN0 papillary thyroid carcinoma.Methods: Databases including PubMed, EMbase,The Cochrane Library(Issue1, 2015), WanFang Data, CBM and CNKI were searched to collect the randomized controlled trails(RCTs)and non-RCTs about TT+PCND versus TT for stage cN0 papillary thyroid carcinoma. The retrieval time was frominception to March 2015. The studies were screened according to the inclusion and exclusion criteria, the data wereextracted and the quality was evaluated by 2 reviewers independently. Then the meta-analysis was conducted usingRevMan 5.1 software. Results: A total of 10 non-RCTs involving 3 661 patients were included. The results of metaanalysis showed that: Related to postoperative complications, Compared with TT, TT+PCND had higher transient hypocalcemia [OR=2.50, 95%CI(2.05, 3.03), P<0.01], higher permanent hypocalcemia [OR=3.11, 95%CI(1.82, 5.30),P<0.01], lower recurrence [OR=0.66, 95%CI(0.47, 0.93), P<0.05]. But there were no differences between the 2 groups in Transient laryngeal nerve palsy and permanent laryngeal nerve palsy. Conclusion: TT+PCND is safe and feasible for treating stage cN0 papillary thyroid carcinoma when its indications are strictly controlled. However, due to limited quantity and quality of the included studies, more high-quality RCT studies are needed to verify the abovementioned conclusion.