The role of prophylactic central compartment neck dissection in papillary thyroid cancer

Abstract

Surgical therapy is the cornerstone of treatment in patients with papillary thyroid cancer (PTC). Surgical therapy in PTC includes half-total or total thyroidectomy (TT) and, in cases of lymph node metastases, cervical lymph node dissection (CLND). The inclusion of prophylactic central compartment neck dissection (pCCND) as a new approach in the management of patients with PTC raised controversies among the community of endocrine surgeons and triggered a plethora of studies comparing TT with or without pCCND, focusing mainly on the rate of complications and the risk of recurrence of the disease. The confliction in the results of meta-analyses and systematic reviews highlights a number of issues regarding the necessity, morbidity and utility of pCCND for patients with PTC undergoing surgery, which need to be studied further. The controversies surrounding pCCND are reflected in the heterogeneity of recommendations for pCCND as reported in the guidelines for the treatment of patients with PTC worldwide. It can be concluded that in order to determine specific recommendations on the indication of pCCND for the treatment of patients with PTC, there are issues that still need to be further investigated. Until then, a more selective choice of patients undergoing pCCND is indicated.