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Abstract：
BACKGROUND: For papillary thyroid microcarcinoma patients, the reported incidence of lymph node metastasis is as high as 40%, and these occur mainly in the central compartment of the neck. Because these metastases are difficult to detect using ultrasonography preoperatively, some authors advocate routine central neck dissection in papillary thyroid microcarcinoma patients at the time of initial thyroidectomy.
OBJECTIVE: To evaluate whether prophylactic central neck dissection can decrease the local recurrence rate of papillary thyroid microcarcinoma after thyroidectomy.
METHODS: The publicly available literature published from January 1990 to December 2017 concerning thyroidectomy plus prophylactic central neck dissection versus thyroidectomy for papillary thyroid microcarcinoma was retrieved by searching the national and international online databases. A meta-analysis was performed after the data extraction process.
RESULTS: Four studies were finally included with a total of 727 patients, of whom, 366 cases underwent thyroidectomy plus prophylactic central neck dissection and 361 cases received thyroidectomy only. As shown by the meta-analysis results, the recurrence rates in cases of thyroidectomy plus prophylactic central neck dissection were approximately 1.91% and were significantly lower than those with thyroidectomy only (OR=0.24, 95% CI [0.10, 0.56], p=0.0009).
CONCLUSIONS: For patients with papillary thyroid microcarcinoma, thyroidectomy plus prophylactic central neck dissection is a safe and efficient procedure and it results in lower recurrence rate. Since the evidences are of low quality (non-randomized studies), further randomized trials are needed.
OBJECTIVE: To evaluate whether prophylactic central neck dissection can decrease the local recurrence rate of papillary thyroid microcarcinoma after thyroidectomy.
METHODS: The publicly available literature published from January 1990 to December 2017 concerning thyroidectomy plus prophylactic central neck dissection versus thyroidectomy for papillary thyroid microcarcinoma was retrieved by searching the national and international online databases. A meta-analysis was performed after the data extraction process.
RESULTS: Four studies were finally included with a total of 727 patients, of whom, 366 cases underwent thyroidectomy plus prophylactic central neck dissection and 361 cases received thyroidectomy only. As shown by the meta-analysis results, the recurrence rates in cases of thyroidectomy plus prophylactic central neck dissection were approximately 1.91% and were significantly lower than those with thyroidectomy only (OR=0.24, 95% CI [0.10, 0.56], p=0.0009).
CONCLUSIONS: For patients with papillary thyroid microcarcinoma, thyroidectomy plus prophylactic central neck dissection is a safe and efficient procedure and it results in lower recurrence rate. Since the evidences are of low quality (non-randomized studies), further randomized trials are needed.
摘要：
背景：对于甲状腺微小乳头状癌患者，据报道，淋巴结转移的发生率高达40%，这些主要发生在颈部的中央隔室。因为术前超声检查很难检测到这些转移，一些作者主张在初次甲状腺切除术时对甲状腺微小乳头状癌患者进行常规中央颈清扫术。
目的：探讨预防性中央颈清扫术能否降低甲状腺乳头状微小癌术后局部复发率。
方法：通过检索国家和国际在线数据库，检索了1990年1月至2017年12月发表的关于甲状腺乳头状微小癌的甲状腺切除术加预防性中央颈清扫术与甲状腺切除术的公开文献。在数据提取过程后进行荟萃分析。
结果：最终纳入了四项研究，共727名患者，谁,366例接受甲状腺切除术加预防性中央颈清扫术，361例仅接受甲状腺切除术。如荟萃分析结果所示，甲状腺切除术加预防性中央颈清扫术的复发率约为1.91％，明显低于仅甲状腺切除术的复发率（OR=0.24，95％CI[0.10，0.56]，p=0.0009)。
结论：对于甲状腺微小乳头状癌患者，甲状腺切除术加预防性中央颈清扫术是一种安全有效的手术方法，可降低复发率。由于证据质量低(非随机研究)，还需要进一步的随机试验.
目的：探讨预防性中央颈清扫术能否降低甲状腺乳头状微小癌术后局部复发率。
方法：通过检索国家和国际在线数据库，检索了1990年1月至2017年12月发表的关于甲状腺乳头状微小癌的甲状腺切除术加预防性中央颈清扫术与甲状腺切除术的公开文献。在数据提取过程后进行荟萃分析。
结果：最终纳入了四项研究，共727名患者，谁,366例接受甲状腺切除术加预防性中央颈清扫术，361例仅接受甲状腺切除术。如荟萃分析结果所示，甲状腺切除术加预防性中央颈清扫术的复发率约为1.91％，明显低于仅甲状腺切除术的复发率（OR=0.24，95％CI[0.10，0.56]，p=0.0009)。
结论：对于甲状腺微小乳头状癌患者，甲状腺切除术加预防性中央颈清扫术是一种安全有效的手术方法，可降低复发率。由于证据质量低(非随机研究)，还需要进一步的随机试验.
