Significance of neck dissection for the treatment of clinically-evident medullary thyroid carcinomas: A systematic review

Auris Nasus Larynx. 2019 Jun;46(3):417-423. doi: 10.1016/j.anl.2018.08.017. Epub 2018 Sep 17.

Abstract

Objective: The survival benefit of prophylactic lateral neck dissection in medullary thyroid carcinomas remains unclear; thus, recent clinical guidelines have deferred the recommendation of lateral neck dissection. This review is to assess the role of lateral neck dissection in treatment of clinically overt medullary thyroid carcinoma.

Methods: A meta-analysis was performed on full-text publications written in English sourced using Embase and Medline databases. Publications with data regarding lateral neck dissection and clinical outcome were included.

Results: The frequently performed central neck dissection was significantly correlated with a higher biological cure rate (p=0.047) and lower structural recurrence rate (p=0.002). The frequency of ipsilateral lateral neck dissection was significantly negatively correlated with the rate of died of disease (p=0.017).

Conclusion: The frequency of lateral neck dissections and rate of died of disease had a reverse correlation suggesting that prophylactic lateral neck dissection has a significant impact on survival.

Keywords: Lateral neck node; Medullary thyroid carcinoma; Neck dissection; Survival; Systematic review.

Publication types

  • Systematic Review

MeSH terms

  • Carcinoma, Medullary / mortality
  • Carcinoma, Medullary / surgery*
  • Humans
  • Neck Dissection / methods*
  • Survival Rate
  • Thyroid Neoplasms / mortality
  • Thyroid Neoplasms / surgery*