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World J Clin Oncol. Jul 24, 2023; 14(7): 247-258
Published online Jul 24, 2023. doi: 10.5306/wjco.v14.i7.247
Role of prophylactic central neck lymph node dissection for papillary thyroid carcinoma in the era of de-escalation
Efstathios T Pavlidis, Theodoros E Pavlidis
Efstathios T Pavlidis, Theodoros E Pavlidis, 2nd Propedeutic Department of Surgery, Hippocration Hospital, School of Medicine, Aristotle University of Thessaloniki, Thessaloniki 54642, Greece
Author contributions: Pavlidis TE designed research, contributed new analytic tools, analyzed data and review; Pavlidis ET performed research, analyzed data review and wrote the paper.
Conflict-of-interest statement: There is no conflict of interest associated with any of the senior author or other coauthors contributed their efforts in this manuscript.
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: https://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Theodoros E Pavlidis, Doctor, PhD, Full Professor, Surgeon, 2nd Propedeutic Department of Surgery, Hippocration Hospital, School of Medicine, Aristotle University of Thessaloniki, Konstantinoupoleos 49, Thessaloniki 54642, Greece. pavlidth@auth.gr
Received: April 24, 2023
Peer-review started: April 24, 2023
First decision: June 14, 2023
Revised: June 14, 2023
Accepted: July 3, 2023
Article in press: July 3, 2023
Published online: July 24, 2023
Core Tip

Core Tip: Nodal status in papillary thyroid cancer patients plays an important role in the prognosis of risk for recurrence. Preoperative evaluation is crucial for minimizing the possible risk of injury from overtreatment. Undoubtedly, therapeutic central neck dissection in addition to total thyroidectomy should be performed if there is positive lymph node involvement. The role of prophylactic central neck lymph node dissection in patients with papillary thyroid carcinoma with negative lymph nodes has been debated. It is currently recommended for T3 and T4 tumors but not for T1 and T2 tumors without high-risk prediction factors of recurrence.