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Is prophylactic central neck dissection necessaryfor cN0 differentiated thyroid cancer patients at initial treatment? A meta-analysis of the literature

View Article: PubMed Central - PubMed

ABSTRACT

Central lymph node metastases are common in patients with differentiated thyroid cancer (DTC). The management of preoperatively nodenegative (cN0) DTC is still under debate. The aim of this study was to analyse the difference in recurrence and surgical complications between thyroidectomy (TT) alone and TT combined with prophylactic central neck dissection (pCND) as initial treatments to DTC patients with cN0 and evaluate the clinic significance of pCND for these patients. PubMed, Ovid, Cochrane Library, and Web of Science databases were systematically searched using multiple search terms. Twenty-three articles with 6,823 patients were identified. The quality of evidence was assessed by Jadad quality scores and the Newcastle-Ottawa Quality assessment scale. The results showed that compared with patients who underwent TT alone, patients who underwent TT plus pCND had a significant higher rate of transient recurrent laryngeal nerve injury (p = 0.023), transient hypocalcaemia (p < 0.01) and permanent hypocalcaemia (p<0.01). There was a trend towards lower central neck recurrence rate in TT plus pCND (p < 0.01). Combined TT and pCND as initial treatment for DTC patients with cN0 may reduce the risk of recurrence, but increases the incidence of some complications. Methodologically high-quality comparative studies are needed for further evaluation.

No MeSH data available.


Egger's publication bias plot showed no publication bias for transient RLN injury.
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Figure 3: Egger's publication bias plot showed no publication bias for transient RLN injury.

Mentions: A single study involved in this meta-analysis was deleted to reflect the influence of the individual data set to the pooled RRs, and the corresponding pooled RRs were not substantially altered. Begg's funnel plot and Egger's test were performed to access the publication bias of literatures. The shape of the funnel plot did not reveal any evidence of obvious asymmetry (Fig. 2). Next, the Egger's test was used to provide statistical evidence of funnel plot symmetry (Fig. 3). Similarly, the results did not suggest any evidence of publication bias.


Is prophylactic central neck dissection necessaryfor cN0 differentiated thyroid cancer patients at initial treatment? A meta-analysis of the literature
Egger's publication bias plot showed no publication bias for transient RLN injury.
© Copyright Policy - open-access
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC5384304&req=5

Figure 3: Egger's publication bias plot showed no publication bias for transient RLN injury.
Mentions: A single study involved in this meta-analysis was deleted to reflect the influence of the individual data set to the pooled RRs, and the corresponding pooled RRs were not substantially altered. Begg's funnel plot and Egger's test were performed to access the publication bias of literatures. The shape of the funnel plot did not reveal any evidence of obvious asymmetry (Fig. 2). Next, the Egger's test was used to provide statistical evidence of funnel plot symmetry (Fig. 3). Similarly, the results did not suggest any evidence of publication bias.

View Article: PubMed Central - PubMed

ABSTRACT

Central lymph node metastases are common in patients with differentiated thyroid cancer (DTC). The management of preoperatively nodenegative (cN0) DTC is still under debate. The aim of this study was to analyse the difference in recurrence and surgical complications between thyroidectomy (TT) alone and TT combined with prophylactic central neck dissection (pCND) as initial treatments to DTC patients with cN0 and evaluate the clinic significance of pCND for these patients. PubMed, Ovid, Cochrane Library, and Web of Science databases were systematically searched using multiple search terms. Twenty-three articles with 6,823 patients were identified. The quality of evidence was assessed by Jadad quality scores and the Newcastle-Ottawa Quality assessment scale. The results showed that compared with patients who underwent TT alone, patients who underwent TT plus pCND had a significant higher rate of transient recurrent laryngeal nerve injury (p = 0.023), transient hypocalcaemia (p < 0.01) and permanent hypocalcaemia (p<0.01). There was a trend towards lower central neck recurrence rate in TT plus pCND (p < 0.01). Combined TT and pCND as initial treatment for DTC patients with cN0 may reduce the risk of recurrence, but increases the incidence of some complications. Methodologically high-quality comparative studies are needed for further evaluation.

No MeSH data available.