Effectiveness of Prophylactic Central Neck Dissection in Intermediate-Risk Papillary Thyroid Cancer

Objective: The role of prophylactic central neck dissection is still controversial in patients with papillary thyroid carcinoma with intermediate risk, especially those without evidence of metastasis. We therefore aimed to assess its impact on locoregional and survival outcomes. Methods: A retrospective cohort study was conducted at the Department of Otolaryngology Head and Neck Surgery of a tertiary-care hospital. Results: Of 469 patients with confirmed papillary thyroid carcinoma, 157 patients underwent prophylactic central neck dissection and 312 patients did not. The recurrence-free survival time was 2.14 years in the group that underwent central neck dissection and 3.58 years in the other, under the mean follow-up time of 5.8 years (SD 2.6), showing no statistical significance. Of the 82 patients with recurrence, 35.3% underwent central neck dissection while 64.6% did not have the operation. Although the difference between the two groups was statistically insignificant, the number of recurrences seems to be higher in those who did not undergo prophylactic central neck dissection. Conclusion: The study reveals no superiority of prophylactic central neck dissection over no central neck dissection in terms of both recurrence-free survival time and recurrence outcomes. Future studies are needed to refine more effective treatment strategies and develop impactful guidelines. Level of Evidence: 2.