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首页> 美国卫生研究院文献>Gland Surgery >The pros and cons of routine central compartment neck dissection for clinically nodal negative (cN0) papillary thyroid cancer
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The pros and cons of routine central compartment neck dissection for clinically nodal negative (cN0) papillary thyroid cancer

机译：常规中央区室颈淋巴结清扫术对淋巴结阴性（cN0）甲状腺乳头状癌的利弊

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摘要

Metastatic disease to regional lymph nodes (LNs) is common in papillary thyroid carcinoma (PTC). LN dissection is increasingly performed as part of the surgical management of PTC. The role of prophylactic central neck dissection (pCND) in PTC is unclear. There is limited evidence to support a routine pCND in clinical setting for nodal negative (cN0) PTC. The aim of this review was to examine the pros and cons of prophylactic neck dissection in cN0 PTC. In summary, the advantages of pCND are: removal of the central LNs that potentially harbor micro-metastases, more accurate staging of disease in order to plan more individualized management, reducing the need for re-operation to remove the metastatic LNs which have developed later and possible improvement in overall survival. The disadvantages are: an extensive surgery but lack of evidence of survival benefit, higher incidence of complications with little impact on local recurrence rate, possibility of over treating in cN0 patients and it does not sound like a cost effective approach in the management of small thyroid cancer. Considering low frequency of permanent morbidity, some authors believe that prophylactic neck dissection is safe in experienced hands even though its prognostic benefit has yet to be demonstrated.
机译：甲状腺乳头状癌（PTC）常见到局部淋巴结转移（LNs）的疾病。 LN解剖越来越多地作为PTC外科治疗的一部分进行。预防性中央颈清扫术（pCND）在PTC中的作用尚不清楚。仅有有限的证据支持在临床中对淋巴结阴性（cN0）PTC使用常规pCND。这篇综述的目的是探讨cN0 PTC预防性颈淋巴清扫术的利弊。总之，pCND的优点是：去除可能带有微小转移的中央LN，更准确的疾病分期以计划更个性化的治疗，减少再次手术以去除后来发展的转移性LN的需要。并可能改善整体生存率。缺点是：广泛的手术但缺乏生存获益的证据，并发症的发生率高，对局部复发率影响不大，在cN0患者中过度治疗的可能性，在小甲状腺的治疗中听起来不像一种经济有效的方法癌症。考虑到永久性发病的发生率较低，一些作者认为，即使有预后的益处，预防性颈淋巴清扫术在经验丰富的手中是安全的。

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