Predictive Factors of Lymph Nodes Recurrence in Patients with Differentiated Thyroid Carcinoma Post Thyroidectomy in Clinically Node Negative Patients: A Systematic Review and Meta-Analysis Study

Abstract

Abstract Background Differentiated thyroid cancer (DTC), a term used to describe papillary thyroid cancer (PTC), follicular thyroid cancer (FTC), and Hürthle cell thyroid cancer (HTC), accounts for approximately 95% of all thyroid malignancies. The expression clinically lymph node-negative (cN0)‘ was used to describe the patients that did not show the clinical evidence of CLNM on US or other imaging modalities preoperatively. Objective To assess the incidence of recurrence after surgery for DTC and to identify predictive factors of recurrence. Patients and Methods The search was conducted through PubMed, Web of science, Scopes, and the Cochrane Library for data from inception to November 1, 2021 with a combination of the following terms: "clinically node negative", "Risk Factors" and "Thyroid Neoplasms". All the studies were reviewed according to the eligible criteria. Abstract-based eligibility studies were obtained, and the manuscripts were fully reviewed. Results There was no evidence of publication bias. The funnel plot analysis demonstrated a symmetrical appearance, and the P values were greater than 0.05 for all comparisons according to the Begg-Mazumdar test and eggers test. Data Sources Medline databases (PubMed, Medscape, ScienceDirect. EMF-Portal) and all materials available in the Internet till 2021. Data Extraction If the studies did not fulfill the inclusion criteria, they were excluded. Study quality assessment included whether ethical approval was gained, eligibility criteria specified, appropriate controls, and adequate information and defined assessment meas ures. Conclusion Young age (<45 years), male gender, Bilaterality, multifocality, capsular invasion, lymphovascular invasion and ETE were significantly associated with LNM in clinically N0 DTC patients and Prophylactic central neck dissection would be expected to have higher yield in patients with these factors.