Is prophylactic central neck dissection necessary for patients with clinically node-negative papillary thyroid microcarcinoma? A follow-up study of more than 10 years
BackgroundTherapeutic central neck dissection (CND) is strongly recommended for patients with clinically node-positive (cN1) papillary thyroid carcinoma (PTC). However, the role of prophylactic central neck dissection (PCND) remains controversial for clinically node-negative (cN0) PTC, particularly...
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Frontiers Media S.A.
2025-05-01
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| Series: | Frontiers in Endocrinology |
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| Online Access: | https://www.frontiersin.org/articles/10.3389/fendo.2025.1597661/full |
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| author | Zeng-Gui Wu Wen-Ting Zheng Li-Jie Chen Fang-Shuang Zhu Zhao-Sheng Ma Fei-Lin Cao Bin-Bin Cui Bo-Jian Xie Xing-Qiang Yan |
| author_facet | Zeng-Gui Wu Wen-Ting Zheng Li-Jie Chen Fang-Shuang Zhu Zhao-Sheng Ma Fei-Lin Cao Bin-Bin Cui Bo-Jian Xie Xing-Qiang Yan |
| author_sort | Zeng-Gui Wu |
| collection | DOAJ |
| description | BackgroundTherapeutic central neck dissection (CND) is strongly recommended for patients with clinically node-positive (cN1) papillary thyroid carcinoma (PTC). However, the role of prophylactic central neck dissection (PCND) remains controversial for clinically node-negative (cN0) PTC, particularly in papillary thyroid microcarcinoma (PTMC). To better elucidate the benefits and disadvantages, we conducted a retrospective analysis with a follow-up of more than 10 years.MethodsA total of 377 consecutive patients were enrolled in this study between April 2011 and March 2015. 146 patients underwent total thyroidectomy alone (TT group), while 231 patients underwent total thyroidectomy and prophylactic central compartment lymph node dissection (TT+PCND group). Considering the low risk of recurrence, all patients did not receive radioiodine treatment. Post-surgical pathological and preoperative clinical courses, local recurrence, postoperative complications, and follow-up data were all collected.ResultsIn the TT+PCND group, 82 patients (35.3%) had occult lymph node metastasis and a higher risk of postoperative complications, including lymphatic leakage, recurrent laryngeal nerve injury, hypoparathyroidism, and accidental parathyroidectomy. Hypoparathyroidism and accidental parathyroidectomy showed a significantly increased risk (p = 0.005, p = 0.049). However, there were no differences in survival and recurrence rates between the two groups.ConclusionsRoutine prophylactic central neck dissection is unnecessary for patients with clinically node-negative papillary thyroid microcarcinoma, as the postoperative complications are significant, while the benefits remain unclear. |
| format | Article |
| id | doaj-art-3231e79337e94211aa5ce55e8eea4d11 |
| institution | Kabale University |
| issn | 1664-2392 |
| language | English |
| publishDate | 2025-05-01 |
| publisher | Frontiers Media S.A. |
| record_format | Article |
| series | Frontiers in Endocrinology |
| spelling | doaj-art-3231e79337e94211aa5ce55e8eea4d112025-08-20T03:49:41ZengFrontiers Media S.A.Frontiers in Endocrinology1664-23922025-05-011610.3389/fendo.2025.15976611597661Is prophylactic central neck dissection necessary for patients with clinically node-negative papillary thyroid microcarcinoma? A follow-up study of more than 10 yearsZeng-Gui WuWen-Ting ZhengLi-Jie ChenFang-Shuang ZhuZhao-Sheng MaFei-Lin CaoBin-Bin CuiBo-Jian XieXing-Qiang YanBackgroundTherapeutic central neck dissection (CND) is strongly recommended for patients with clinically node-positive (cN1) papillary thyroid carcinoma (PTC). However, the role of prophylactic central neck dissection (PCND) remains controversial for clinically node-negative (cN0) PTC, particularly in papillary thyroid microcarcinoma (PTMC). To better elucidate the benefits and disadvantages, we conducted a retrospective analysis with a follow-up of more than 10 years.MethodsA total of 377 consecutive patients were enrolled in this study between April 2011 and March 2015. 146 patients underwent total thyroidectomy alone (TT group), while 231 patients underwent total thyroidectomy and prophylactic central compartment lymph node dissection (TT+PCND group). Considering the low risk of recurrence, all patients did not receive radioiodine treatment. Post-surgical pathological and preoperative clinical courses, local recurrence, postoperative complications, and follow-up data were all collected.ResultsIn the TT+PCND group, 82 patients (35.3%) had occult lymph node metastasis and a higher risk of postoperative complications, including lymphatic leakage, recurrent laryngeal nerve injury, hypoparathyroidism, and accidental parathyroidectomy. Hypoparathyroidism and accidental parathyroidectomy showed a significantly increased risk (p = 0.005, p = 0.049). However, there were no differences in survival and recurrence rates between the two groups.ConclusionsRoutine prophylactic central neck dissection is unnecessary for patients with clinically node-negative papillary thyroid microcarcinoma, as the postoperative complications are significant, while the benefits remain unclear.https://www.frontiersin.org/articles/10.3389/fendo.2025.1597661/fullpapillary thyroid microcarcinoma (PTMC)prophylactic central neck dissection (pCND)postoperative complicationsclinically node-negative (cN0)total thyroidectomy (TT) |
| spellingShingle | Zeng-Gui Wu Wen-Ting Zheng Li-Jie Chen Fang-Shuang Zhu Zhao-Sheng Ma Fei-Lin Cao Bin-Bin Cui Bo-Jian Xie Xing-Qiang Yan Is prophylactic central neck dissection necessary for patients with clinically node-negative papillary thyroid microcarcinoma? A follow-up study of more than 10 years Frontiers in Endocrinology papillary thyroid microcarcinoma (PTMC) prophylactic central neck dissection (pCND) postoperative complications clinically node-negative (cN0) total thyroidectomy (TT) |
| title | Is prophylactic central neck dissection necessary for patients with clinically node-negative papillary thyroid microcarcinoma? A follow-up study of more than 10 years |
| title_full | Is prophylactic central neck dissection necessary for patients with clinically node-negative papillary thyroid microcarcinoma? A follow-up study of more than 10 years |
| title_fullStr | Is prophylactic central neck dissection necessary for patients with clinically node-negative papillary thyroid microcarcinoma? A follow-up study of more than 10 years |
| title_full_unstemmed | Is prophylactic central neck dissection necessary for patients with clinically node-negative papillary thyroid microcarcinoma? A follow-up study of more than 10 years |
| title_short | Is prophylactic central neck dissection necessary for patients with clinically node-negative papillary thyroid microcarcinoma? A follow-up study of more than 10 years |
| title_sort | is prophylactic central neck dissection necessary for patients with clinically node negative papillary thyroid microcarcinoma a follow up study of more than 10 years |
| topic | papillary thyroid microcarcinoma (PTMC) prophylactic central neck dissection (pCND) postoperative complications clinically node-negative (cN0) total thyroidectomy (TT) |
| url | https://www.frontiersin.org/articles/10.3389/fendo.2025.1597661/full |
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