Abstract
Background
The efficacy of prophylactic central compartment lymph node dissection for papillary
thyroid carcinoma remains controversial. We performed a randomized controlled trial
to evaluate the efficacy and safety of prophylactic central compartment lymph node
dissection in patients with papillary thyroid carcinoma.
Methods
In this parallel-group randomized controlled trial, we assessed 101 patients aged
20 to 70 years with small/noninvasive papillary thyroid carcinoma and no clinical
metastases or history of cervical surgery/radiation exposure. Randomization ran from
April 2015 to November 2017. Data were collected between April 2015 and October 2020.
Of the 101 enrolled patients, 50 underwent total thyroidectomy (TTx group) and 51
underwent total thyroidectomy as well as prophylactic central compartment lymph node
dissection (TTx+pCND group). Surgical completeness, local recurrence, successful ablation,
postoperative complication, and papillary thyroid carcinoma upstaging were compared
between the 2 groups.
Results
No patient showed structural recurrence after 46.6 ± 9.1 months of follow-up. Both
groups had similar rates of surgical completeness and successful ablation. There was
no difference in the incidence of complications. More patients were upstaged to pN1a
in the TTx+pCND group compared to those in the TTx group (P < .05).
Conclusions
Prophylactic central compartment lymph node dissection detected more lymph node metastases
but did not affect recurrence. The 2 groups showed similar outcomes with regard to
surgical completeness, successful ablation, and complications. In conclusion, for
small/noninvasive papillary thyroid carcinoma without clinical evidence of lymph node
metastases, prophylactic central compartment lymph node dissection may not be required
if total thyroidectomy is planned.
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Article info
Publication history
Published online: August 12, 2021
Accepted:
March 29,
2021
Identification
Copyright
© 2021 Published by Elsevier Inc.
