Role of Prophylactic Thyroid Neck Dissection in Papillary Thyroid Cancer

Abstract

Background: the utility and efficacy of prophylactic central neck dissection with total thyroidectomy for treatment of differentiated thyroid cancers has been debated in the literature over the past few decades. Proponents of prophylactic central neck dissection support its routine use with the notion that it reduces local recurrence, increases accuracy in TNM staging and reduces surgical morbidity associated with reoperation. Conversely, those against the use of routine prophylactic central neck dissection argue there was no clear evidence which showed a reduction in recurrence or added benefit to survival, while the procedure increased the risk for complications and morbidity. This article discussed the role of prophylactic central neck dissection in the setting of thyroid cancer and reviewed recently published literatures to evaluate efficacy and safety of this procedure.The papillary thyroid carcinoma (PTC) is the most common disorder with favorable prognosis around the world. PTC has 90% survival rate, but the most important challenge was the lymph node metastases that would result in disease recurrence. There is a debate about the utility of prophylactic central neck dissection in the area of PTC. The available studies for performing PCND showed a difficulty in predicting its outcomes, but PCND could provide potential reduction in the recurrence rates and risks of performing another surgery in the neck. This review discussed the PCND advantages compared to its long term outcomes and morbidity.