Effectiveness of prophylactic central compartment neck dissection following Hemithyroidectomy in papillary thyroid cancer: a meta-analysis

Introduction: In this study, we aimed to assess the effect of prophylactic central compartment neck dissection (pCCND) in conjunction with hemithyroidectomy (HT) for clinically low-risk node-negative (cN0) papillary thyroid carcinoma (PTC).

Methods: A thorough literature search was performed utilizing PubMed and EMBASE for articles published until October 2023. Subsequently, a meta-analysis was performed on studies involving patients with cN0 PTC, with postoperative locoregional recurrence (LRR) and survival data, treated with HT + pCCND or HT. The study was registered with PROSPERO (CRD42024560962).

Results: We included seven studies in this meta-analysis, including 2132 patients who met the inclusion criteria: six retrospective cohort studies and one randomized controlled trial. The HT + pCCND group consisted of 1090 cases, and the HT group had 1042 cases. The LRR rates after HT with or without pCCND were similar (3.58% vs. 4.51%; odds ratio (OR) = 0.65; 95% confidence interval (CI) = 0.41-1.03). Five of the seven studies provided prognostic and survival data, particularly the log hazard ratio (log HR) of disease-free survival (DFS) between the two groups. There was also no significant difference in terms of DFS between the HT + pCCND and HT groups (OR = 0.67; 95% CI = 0.42-1.07).

Conclusions: There was no significant difference in LRR and DFS between the HT + pCCND and HT groups. pCCND did not demonstrate significant efficacy in improving oncological outcomes for low-risk patients with cN0 PTC. Therefore, for patients with low-risk cN0 PTC, thyroid surgeons should make reasonable and individualized decisions regarding the extent of surgical removal.