Prophylactic central neck dissection and local recurrence in papillary thyroid cancer: A meta-analysis

Tarek Zetoune, Xavier Keutgen, Daniel Buitrago, Hasan Aldailami, Huibo Shao, Madhu Mazumdar, Thomas J. Fahey, Rasa Zarnegar

Research output: Contribution to journalArticle

106 Citations (Scopus)

Abstract

Background: The effectiveness of prophylactic central neck dissection (pCND) in the treatment of patients with papillary thyroid carcinoma (PTC) to prevent local recurrence is controversial. We performed a meta-analysis to assess the effect of pCND on local recurrence in PTC. Methods: Exhaustive search of online search engines identified five retrospective studies that compared the local recurrence rates of PTC in patients without clinically detectable nodal disease in patients undergoing thyroidectomy + pCND (group A) to those undergoing thyroidectomy alone (group B). A meta-analysis was performed by the fixed effects method. Recurrence was documented by imaging, thyroglobulin detection, or reoperation. Location of recurrence was identified in either the central or lateral neck compartment. Results: A total of 1264 patients were included, 396 in group A and 868 in group B. Follow-up ranged from 6 months to 27 years. The overall recurrence rate was 2.02% in group A versus 3.92% in group B (odds ratio [OR] = 1.05, 95% confidence interval [95% CI] 0.48-2.31). The recurrence rate in the central neck compartment in group A was 1.86% compared to 1.68% in group B (OR = 1.31, 95% CI 0.44-3.91). The recurrence rate in the lateral neck compartment in group A was 3.73% compared to 3.79% in group B (OR = 1.21, 95% CI 0.52-2.75). There was no statistically significant difference in the OR in the local recurrence between the two groups. Conclusions: This meta-analysis indicates that pCND does not greatly reduce local recurrence in thyroid cancer. However, the available studies have substantial limitations and a prospective multicenter study to determine the indications for pCND is warranted.

Original languageEnglish (US)
Pages (from-to)3287-3293
Number of pages7
JournalAnnals of Surgical Oncology
Volume17
Issue number12
DOIs
StatePublished - Dec 1 2010
Externally publishedYes

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Neck Dissection
Meta-Analysis
Recurrence
Odds Ratio
Neck
Thyroidectomy
Confidence Intervals
Papillary Thyroid cancer
Search Engine
Thyroglobulin
Reoperation
Thyroid Neoplasms
Multicenter Studies
Retrospective Studies
Prospective Studies

ASJC Scopus subject areas

  • Surgery
  • Oncology

Cite this

Prophylactic central neck dissection and local recurrence in papillary thyroid cancer : A meta-analysis. / Zetoune, Tarek; Keutgen, Xavier; Buitrago, Daniel; Aldailami, Hasan; Shao, Huibo; Mazumdar, Madhu; Fahey, Thomas J.; Zarnegar, Rasa.

In: Annals of Surgical Oncology, Vol. 17, No. 12, 01.12.2010, p. 3287-3293.

Research output: Contribution to journalArticle

Zetoune, T, Keutgen, X, Buitrago, D, Aldailami, H, Shao, H, Mazumdar, M, Fahey, TJ & Zarnegar, R 2010, 'Prophylactic central neck dissection and local recurrence in papillary thyroid cancer: A meta-analysis', Annals of Surgical Oncology, vol. 17, no. 12, pp. 3287-3293. https://doi.org/10.1245/s10434-010-1137-6
Zetoune, Tarek ; Keutgen, Xavier ; Buitrago, Daniel ; Aldailami, Hasan ; Shao, Huibo ; Mazumdar, Madhu ; Fahey, Thomas J. ; Zarnegar, Rasa. / Prophylactic central neck dissection and local recurrence in papillary thyroid cancer : A meta-analysis. In: Annals of Surgical Oncology. 2010 ; Vol. 17, No. 12. pp. 3287-3293.
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abstract = "Background: The effectiveness of prophylactic central neck dissection (pCND) in the treatment of patients with papillary thyroid carcinoma (PTC) to prevent local recurrence is controversial. We performed a meta-analysis to assess the effect of pCND on local recurrence in PTC. Methods: Exhaustive search of online search engines identified five retrospective studies that compared the local recurrence rates of PTC in patients without clinically detectable nodal disease in patients undergoing thyroidectomy + pCND (group A) to those undergoing thyroidectomy alone (group B). A meta-analysis was performed by the fixed effects method. Recurrence was documented by imaging, thyroglobulin detection, or reoperation. Location of recurrence was identified in either the central or lateral neck compartment. Results: A total of 1264 patients were included, 396 in group A and 868 in group B. Follow-up ranged from 6 months to 27 years. The overall recurrence rate was 2.02{\%} in group A versus 3.92{\%} in group B (odds ratio [OR] = 1.05, 95{\%} confidence interval [95{\%} CI] 0.48-2.31). The recurrence rate in the central neck compartment in group A was 1.86{\%} compared to 1.68{\%} in group B (OR = 1.31, 95{\%} CI 0.44-3.91). The recurrence rate in the lateral neck compartment in group A was 3.73{\%} compared to 3.79{\%} in group B (OR = 1.21, 95{\%} CI 0.52-2.75). There was no statistically significant difference in the OR in the local recurrence between the two groups. Conclusions: This meta-analysis indicates that pCND does not greatly reduce local recurrence in thyroid cancer. However, the available studies have substantial limitations and a prospective multicenter study to determine the indications for pCND is warranted.",
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T1 - Prophylactic central neck dissection and local recurrence in papillary thyroid cancer

T2 - A meta-analysis

AU - Zetoune, Tarek

AU - Keutgen, Xavier

AU - Buitrago, Daniel

AU - Aldailami, Hasan

AU - Shao, Huibo

AU - Mazumdar, Madhu

AU - Fahey, Thomas J.

AU - Zarnegar, Rasa

PY - 2010/12/1

Y1 - 2010/12/1

N2 - Background: The effectiveness of prophylactic central neck dissection (pCND) in the treatment of patients with papillary thyroid carcinoma (PTC) to prevent local recurrence is controversial. We performed a meta-analysis to assess the effect of pCND on local recurrence in PTC. Methods: Exhaustive search of online search engines identified five retrospective studies that compared the local recurrence rates of PTC in patients without clinically detectable nodal disease in patients undergoing thyroidectomy + pCND (group A) to those undergoing thyroidectomy alone (group B). A meta-analysis was performed by the fixed effects method. Recurrence was documented by imaging, thyroglobulin detection, or reoperation. Location of recurrence was identified in either the central or lateral neck compartment. Results: A total of 1264 patients were included, 396 in group A and 868 in group B. Follow-up ranged from 6 months to 27 years. The overall recurrence rate was 2.02% in group A versus 3.92% in group B (odds ratio [OR] = 1.05, 95% confidence interval [95% CI] 0.48-2.31). The recurrence rate in the central neck compartment in group A was 1.86% compared to 1.68% in group B (OR = 1.31, 95% CI 0.44-3.91). The recurrence rate in the lateral neck compartment in group A was 3.73% compared to 3.79% in group B (OR = 1.21, 95% CI 0.52-2.75). There was no statistically significant difference in the OR in the local recurrence between the two groups. Conclusions: This meta-analysis indicates that pCND does not greatly reduce local recurrence in thyroid cancer. However, the available studies have substantial limitations and a prospective multicenter study to determine the indications for pCND is warranted.

AB - Background: The effectiveness of prophylactic central neck dissection (pCND) in the treatment of patients with papillary thyroid carcinoma (PTC) to prevent local recurrence is controversial. We performed a meta-analysis to assess the effect of pCND on local recurrence in PTC. Methods: Exhaustive search of online search engines identified five retrospective studies that compared the local recurrence rates of PTC in patients without clinically detectable nodal disease in patients undergoing thyroidectomy + pCND (group A) to those undergoing thyroidectomy alone (group B). A meta-analysis was performed by the fixed effects method. Recurrence was documented by imaging, thyroglobulin detection, or reoperation. Location of recurrence was identified in either the central or lateral neck compartment. Results: A total of 1264 patients were included, 396 in group A and 868 in group B. Follow-up ranged from 6 months to 27 years. The overall recurrence rate was 2.02% in group A versus 3.92% in group B (odds ratio [OR] = 1.05, 95% confidence interval [95% CI] 0.48-2.31). The recurrence rate in the central neck compartment in group A was 1.86% compared to 1.68% in group B (OR = 1.31, 95% CI 0.44-3.91). The recurrence rate in the lateral neck compartment in group A was 3.73% compared to 3.79% in group B (OR = 1.21, 95% CI 0.52-2.75). There was no statistically significant difference in the OR in the local recurrence between the two groups. Conclusions: This meta-analysis indicates that pCND does not greatly reduce local recurrence in thyroid cancer. However, the available studies have substantial limitations and a prospective multicenter study to determine the indications for pCND is warranted.

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