Systematic evaluation of prophylactic neck dissection for the treatment of papillary thyroid carcinoma.

OBJECTIVE

The objective of the study was to evaluate the efficacy of prophylactic neck dissection in the treatment of papillary thyroid cancer and to provide guidelines for clinical practice.

METHOD

Relevant clinical trials on prophylactic neck dissection in the treatment of papillary thyroid cancer were retrieved using PubMed, MEDLINE, EMBASE and Cochrane Controlled Trials Register until August 2012. Information was extracted according to the Cochrane systematic review methods. RevMan 5.0 was used for meta-analysis.

RESULTS

Nine controlled clinical trials were included in this meta-analysis. Compared with patients who underwent thyroidectomy alone (control group), patients who underwent thyroidectomy plus prophylactic neck dissection (experimental group) showed a higher incidence of transient hypocalcemia (P = 0.02), but no significant changes were observed in the incidence of neck lymph node recurrence (P = 0.69), central neck lymph node recurrence (P = 0.61), lateral neck lymph node recurrence (P = 0.70), permanent hypocalcemia (P = 0.44), transient vocal cord paralysis (P = 0.13), permanent vocal cord paralysis (P = 0.26) and hematoma incidence (P = 0.39).

CONCLUSIONS

Combined thyroidectomy and prophylactic neck dissection may be effective in the treatment of patients with papillary thyroid cancer, without more complications compared with thyroidectomy alone.