Outcome of Total Thyroidectomy Versus Total Thyroidectomy + Prophylactic Central Compartment Lymph Node Dissection in Intrathyroidal Papillary Thyroid Carcinoma: A Propensity Score-Matched Analysis

The requirement of prophylactic central compartment (pCCLND) dissection in intrathyroidal PTC remains controversial. The primary objective of this study was to compare disease recurrence rate, and the secondary objective was to compare late morbidity of surgery in PTC patients with cN0 disease undergoing total thyroidectomy (TT) with and without pCCLND. The setting and design are as follows: Tertiary care hospital, retrospective study (January 2000 and December 2020). This study consisted of 134 intrathyroidal PTC patients who underwent either TT (Group A, n = 23) or TT + pCCLND (Group B, n = 111). Both groups were compared with or without propensity score matching. Recurrence rate, disease free survival (DFS), and post-operative morbidity were compared between two groups. There were no significant differences in the distribution of sex, tumor size, or functional status between the groups. In Group B, 41.4% patients had central compartment metastasis. The mean follow-up was 71.6 months. Structural recurrence (8.6%) was found to be significantly high in Group A ( p = 0.02), but on propensity score matching, the difference was not significant. Incidence of permanent hypoparathyroidism was significantly high in Group B ( p = 0.009). The 15-year cumulative recurrence-free survival (RFS) rates of patients in the non-pCCLND and pCCLND groups were 91.3% and 100%, respectively ( p = 0.281). Recurrence rate and DFS was not significantly different in patients with or without pCCLND. Post-operative morbidity is higher in patients undergoing pCCLND.