AUTHOR=Wu Zeng-Gui , Zheng Wen-Ting , Chen Li-Jie , Zhu Fang-Shuang , Ma Zhao-Sheng , Cao Fei-Lin , Cui Bin-Bin , Xie Bo-Jian , Yan Xing-Qiang 

TITLE=Is prophylactic central neck dissection necessary for patients with clinically node-negative papillary thyroid microcarcinoma? A follow-up study of more than 10 years

JOURNAL=Frontiers in Endocrinology

VOLUME=Volume 16 - 2025

YEAR=2025

URL=https://www.frontiersin.org/journals/endocrinology/articles/10.3389/fendo.2025.1597661

DOI=10.3389/fendo.2025.1597661

ISSN=1664-2392

ABSTRACT=BackgroundTherapeutic central neck dissection (CND) is strongly recommended for patients with clinically node-positive (cN1) papillary thyroid carcinoma (PTC). However, the role of prophylactic central neck dissection (PCND) remains controversial for clinically node-negative (cN0) PTC, particularly in papillary thyroid microcarcinoma (PTMC). To better elucidate the benefits and disadvantages, we conducted a retrospective analysis with a follow-up of more than 10 years.MethodsA total of 377 consecutive patients were enrolled in this study between April 2011 and March 2015. 146 patients underwent total thyroidectomy alone (TT group), while 231 patients underwent total thyroidectomy and prophylactic central compartment lymph node dissection (TT+PCND group). Considering the low risk of recurrence, all patients did not receive radioiodine treatment. Post-surgical pathological and preoperative clinical courses, local recurrence, postoperative complications, and follow-up data were all collected.ResultsIn the TT+PCND group, 82 patients (35.3%) had occult lymph node metastasis and a higher risk of postoperative complications, including lymphatic leakage, recurrent laryngeal nerve injury, hypoparathyroidism, and accidental parathyroidectomy. Hypoparathyroidism and accidental parathyroidectomy showed a significantly increased risk (p = 0.005, p = 0.049). However, there were no differences in survival and recurrence rates between the two groups.ConclusionsRoutine prophylactic central neck dissection is unnecessary for patients with clinically node-negative papillary thyroid microcarcinoma, as the postoperative complications are significant, while the benefits remain unclear.