| Prophylactic central neck dissection and local recurrence in papillary thyroid cancer: a meta-analysis. | |
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MedLine Citation:
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PMID: 20596784 Owner: NLM Status: In-Process |
Abstract/OtherAbstract:
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BACKGROUND: The effectiveness of prophylactic central neck dissection (pCND) in the treatment of patients with papillary thyroid carcinoma (PTC) to prevent local recurrence is controversial. We performed a meta-analysis to assess the effect of pCND on local recurrence in PTC. METHODS: Exhaustive search of online search engines identified five retrospective studies that compared the local recurrence rates of PTC in patients without clinically detectable nodal disease in patients undergoing thyroidectomy + pCND (group A) to those undergoing thyroidectomy alone (group B). A meta-analysis was performed by the fixed effects method. Recurrence was documented by imaging, thyroglobulin detection, or reoperation. Location of recurrence was identified in either the central or lateral neck compartment. RESULTS: A total of 1264 patients were included, 396 in group A and 868 in group B. Follow-up ranged from 6 months to 27 years. The overall recurrence rate was 2.02% in group A versus 3.92% in group B (odds ratio [OR] = 1.05, 95% confidence interval [95% CI] 0.48-2.31). The recurrence rate in the central neck compartment in group A was 1.86% compared to 1.68% in group B (OR = 1.31, 95% CI 0.44-3.91). The recurrence rate in the lateral neck compartment in group A was 3.73% compared to 3.79% in group B (OR = 1.21, 95% CI 0.52-2.75). There was no statistically significant difference in the OR in the local recurrence between the two groups. CONCLUSIONS: This meta-analysis indicates that pCND does not greatly reduce local recurrence in thyroid cancer. However, the available studies have substantial limitations and a prospective multicenter study to determine the indications for pCND is warranted. |
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Authors:
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Tarek Zetoune; Xavier Keutgen; Daniel Buitrago; Hasan Aldailami; Huibo Shao; Madhu Mazumdar; Thomas J Fahey; Rasa Zarnegar |
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Publication Detail:
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Type: Journal Article Date: 2010-07-02 |
Journal Detail:
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Title: Annals of surgical oncology Volume: 17 ISSN: 1534-4681 ISO Abbreviation: Ann. Surg. Oncol. Publication Date: 2010 Dec |
Date Detail:
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Created Date: 2010-12-02 Completed Date: - Revised Date: - |
Medline Journal Info:
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Nlm Unique ID: 9420840 Medline TA: Ann Surg Oncol Country: United States |
Other Details:
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Languages: eng Pagination: 3287-93 Citation Subset: IM |
Affiliation:
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Department of Surgery, Weill Cornell Medical College, New York, NY, USA. |
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From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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