Comparison of prophylactic ipsilateral and bilateral central lymph node dissection in papillary thyroid carcinoma: a meta-analysis
Objective: The scope of surgical resection for paratracheal (level VI) lymph nodes in patients with Papillary Thyroid Carcinoma (PTC) remains debatable. The aim of our study was to evaluate the effectiveness and safety of prophylactic ipsilateral Central Neck lymph node Dissection (CND) versus bilat...
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| Format: | Article |
| Language: | English |
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Elsevier
2023-11-01
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| Series: | Brazilian Journal of Otorhinolaryngology |
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| Online Access: | http://www.sciencedirect.com/science/article/pii/S1808869423000861 |
| _version_ | 1797685289635807232 |
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| author | Yujie Li Lingling Lao |
| author_facet | Yujie Li Lingling Lao |
| author_sort | Yujie Li |
| collection | DOAJ |
| description | Objective: The scope of surgical resection for paratracheal (level VI) lymph nodes in patients with Papillary Thyroid Carcinoma (PTC) remains debatable. The aim of our study was to evaluate the effectiveness and safety of prophylactic ipsilateral Central Neck lymph node Dissection (CND) versus bilateral CND at the time of total thyroidectomy for Clinically Node-negative (cN0) unilateral PTC. Methods: A systematic retrieval of electronic databases, including Pubmed, Web of Science, and the China Journal Net, was conducted from January 1990 to September 2021. Outcome data of interest included transient hypoparathyroidism, permanent hypoparathyroidism, transient Recurrent Laryngeal Nerve (RLN) injury, permanent RLN injury and local recurrence. We constructed the summary Odds Ratios (ORs) and 95% Confidence Intervals (CIs) for every study with either fixed or random effect models. Results: A full total of 1792 patients from 6 studies were enrolled. Our meta-analysis showed that transient hypoparathyroidism was significantly more frequent in bilateral CND group (OR = 0.58; 95% CI 0.44–0.76). The prevalence of permanent hypoparathyroidism was significantly higher in bilateral CND group patients compared to those in ipsilateral CND group (OR = 0.26; 95% CI 0.15–0.45). On the other hand, our meta-analysis indicated that there were no significant differences in the incidence of transient RLN injury, permanent RLN injury and local recurrence. Conclusions: Compared with bilateral CND, the rate of temporary and permanent hypoparathyroidism in ipsilateral CND is lower, but the local recurrence is similar. It may be presumptuous to suggest that ipsilateral CND is an adequate treatment for cN0 unilateral PTC. |
| first_indexed | 2024-03-12T00:42:02Z |
| format | Article |
| id | doaj.art-399840281a0b4d5ea873eb382fcf16b2 |
| institution | Directory Open Access Journal |
| issn | 1808-8694 |
| language | English |
| last_indexed | 2024-03-12T00:42:02Z |
| publishDate | 2023-11-01 |
| publisher | Elsevier |
| record_format | Article |
| series | Brazilian Journal of Otorhinolaryngology |
| spelling | doaj.art-399840281a0b4d5ea873eb382fcf16b22023-09-15T04:39:20ZengElsevierBrazilian Journal of Otorhinolaryngology1808-86942023-11-01896101318Comparison of prophylactic ipsilateral and bilateral central lymph node dissection in papillary thyroid carcinoma: a meta-analysisYujie Li0Lingling Lao1Ningbo No.2 Hospital, Department of General Surgery, Ningbo, ChinaYuyao People’s Hospital, Department of General Surgery, Zhejiang Province, China; Corresponding author.Objective: The scope of surgical resection for paratracheal (level VI) lymph nodes in patients with Papillary Thyroid Carcinoma (PTC) remains debatable. The aim of our study was to evaluate the effectiveness and safety of prophylactic ipsilateral Central Neck lymph node Dissection (CND) versus bilateral CND at the time of total thyroidectomy for Clinically Node-negative (cN0) unilateral PTC. Methods: A systematic retrieval of electronic databases, including Pubmed, Web of Science, and the China Journal Net, was conducted from January 1990 to September 2021. Outcome data of interest included transient hypoparathyroidism, permanent hypoparathyroidism, transient Recurrent Laryngeal Nerve (RLN) injury, permanent RLN injury and local recurrence. We constructed the summary Odds Ratios (ORs) and 95% Confidence Intervals (CIs) for every study with either fixed or random effect models. Results: A full total of 1792 patients from 6 studies were enrolled. Our meta-analysis showed that transient hypoparathyroidism was significantly more frequent in bilateral CND group (OR = 0.58; 95% CI 0.44–0.76). The prevalence of permanent hypoparathyroidism was significantly higher in bilateral CND group patients compared to those in ipsilateral CND group (OR = 0.26; 95% CI 0.15–0.45). On the other hand, our meta-analysis indicated that there were no significant differences in the incidence of transient RLN injury, permanent RLN injury and local recurrence. Conclusions: Compared with bilateral CND, the rate of temporary and permanent hypoparathyroidism in ipsilateral CND is lower, but the local recurrence is similar. It may be presumptuous to suggest that ipsilateral CND is an adequate treatment for cN0 unilateral PTC.http://www.sciencedirect.com/science/article/pii/S1808869423000861Papillary thyroid carcinomaIpsilateral CNDBilateral CNDMeta-analysis |
| spellingShingle | Yujie Li Lingling Lao Comparison of prophylactic ipsilateral and bilateral central lymph node dissection in papillary thyroid carcinoma: a meta-analysis Brazilian Journal of Otorhinolaryngology Papillary thyroid carcinoma Ipsilateral CND Bilateral CND Meta-analysis |
| title | Comparison of prophylactic ipsilateral and bilateral central lymph node dissection in papillary thyroid carcinoma: a meta-analysis |
| title_full | Comparison of prophylactic ipsilateral and bilateral central lymph node dissection in papillary thyroid carcinoma: a meta-analysis |
| title_fullStr | Comparison of prophylactic ipsilateral and bilateral central lymph node dissection in papillary thyroid carcinoma: a meta-analysis |
| title_full_unstemmed | Comparison of prophylactic ipsilateral and bilateral central lymph node dissection in papillary thyroid carcinoma: a meta-analysis |
| title_short | Comparison of prophylactic ipsilateral and bilateral central lymph node dissection in papillary thyroid carcinoma: a meta-analysis |
| title_sort | comparison of prophylactic ipsilateral and bilateral central lymph node dissection in papillary thyroid carcinoma a meta analysis |
| topic | Papillary thyroid carcinoma Ipsilateral CND Bilateral CND Meta-analysis |
| url | http://www.sciencedirect.com/science/article/pii/S1808869423000861 |
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