Prophylactic Central Lymph Node Dissection Versus Thyroidectomy Alone in Clinically Node-Negative Thyroid Cancer: A Systematic Review and Meta-Analysis

Background The role of prophylactic central neck dissection (pCND) in clinically node-negative (cN0) thyroid cancer patients remains debated. Although pCND may enhance staging and reduce recurrence, it also carries risks such as hypoparathyroidism and laryngeal nerve injury. This meta-analysis of randomized controlled trials (RCTs) aims to provide more robust evidence regarding the benefits and risks of pCND. Methods A systematic review and meta-analysis were conducted following PRISMA guidelines. Eligible RCTs comparing thyroidectomy with and without pCND were identified through searches of PubMed, EMBASE, Web of Science, and Cochrane Library up to September 2025. Data extraction, bias assessment, and synthesis were independently performed. Results Seven RCTs comprising 1,484 patients were included. pCND significantly increased lymph node metastasis detection (OR 7.43, p