Risk Factors for Central Compartment Lymph Node Metastasis in XXXX : A Meta-Analysis.

@entity1 @entity1600 @entity5 @entity7172
BACKGROUND: The surgical management of @entity7172 ( @entity7172 ), especially regarding the necessity of central lymph node dissection (CLND), remains controversial. This meta-analysis was conducted to investigate the clinicopathologic factors predictive of central @entity1600 ( @entity1600 ) in @entity1 diagnosed with @entity7172 . METHODS: PubMed, EMBASE, Ovid, Web of Science, and the Cochrane Library were searched from their inception to September 2013. Published studies that explored the association between clinicopathologic factors and @entity1600 in @entity7172 @entity1 were included. From the identified studies, we extracted the number of individuals with or without each risk factor to calculate the @entity1600 -positive proportions and used fixed/random-effects models for the meta-analyses of overall relative risk (RR). The pooling analysis on the association between @entity1600 or the different CLNDs and prognosis was also conducted. RESULTS: A total of 19 eligible studies that included 8345 @entity1 were identified. Three studies did therapeutic CLND, while the other 16 studies performed prophylactic CLND in @entity7172 @entity1 . Meta-analyses revealed that @entity1600 was associated with male gender (RR  =  1.36; 95  % CI 1.22-1.52, p  =  0.001), younger age (<45  years; RR  =  1.15; 95  % CI 1.04-1.27, p  =  0.006), larger @entity5 size (>5  mm; RR  =  1.51 95  % CI 1.32-1.65, p  =  0.001), multifocality (RR  =  1.40; 95  % CI 1.27-1.54, p  =  0.001), and extrathyroidal extension (RR  =  1.81; 95  % CI 1.34-2.43, p  =  0.001). Meta-regression analysis indicated that a disparity in the proportion of @entity7172 @entity1 with @entity1600 in each study was the main factor resulting in heterogeneity among the 19 studies. In addition, the pooling analyses suggested that @entity1600 did not significantly predict neck recurrences [hazard ratio (HR)  =  0.95, 95  % CI 0.67-1.22, p  =  0.054], and the prophylactic CLND group did not improve local control significantly compared to the therapeutic group (RR  =  0.96, 95  % CI 0.46-2.01, p  =  0.544). CONCLUSION: Prophylactic CLND may be performed in @entity7172 @entity1 with clinically uninvolved central lymph nodes but with high risk factors; multicenter studies with long-term follow-up are recommended to better understand the risk factors and surgical management for central nodes in @entity7172 .
