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Although therapeutic central neck dissection is recommended for patients with differentiated thyroid cancer with cervical lymph node metastasis, the effectiveness of prophylactic central neck dissection following total thyroidectomy in patients with clinical node-negative differentiated thyroid cancer remains controversial. There are many arguments in favor and many against the execution of prophylactic central neck dissection.
The authors review the most recent literature and illustrate the latest published guidelines, focusing on the currently hottest and most debated points.
Authors conclude that there is still no consensus on the role of prophylactic central neck dissection in clinically node-negative differentiated thyroid carcinoma. Prophylactic central neck dissection is associated with higher rates of hypoparathyroidism and recurrent laryngeal nerve injury with uncertain benefits. So, in the absence of involved lymph nodes, prophylactic central neck dissection should be avoided, reserving it to high-risk patients with advanced primary tumors; prophylactic central neck dissection should be performed by high-volume surgeons to avoid definitive complications.