Comparison of total thyroidectomy and lobectomy for intermediate-risk papillary thyroid carcinoma with lateral lymph node metastasis: a systematic review and meta-analysis

作者：Xinhua Li, Zhiqiang Gui, C. F. Xu, Jingzhe Xiang, Jie Ming, Tao Huang, Ming‐Ming Jiang, Hao Zhang, Zhihong Wang · 发表于：International Journal of Surgery · 年份：2025 · DOI：10.1097/js9.0000000000002673 · 被引用次数：8 · 研究领域：Thyroid Cancer Diagnosis and Treatment、Thyroid and Parathyroid Surgery、Thyroid Disorders and Treatments

BACKGROUND: The 2015 American Thyroid Association guidelines recommend total thyroidectomy (TT) followed by radioactive iodine (RAI) therapy as the primary treatment modality for intermediate-risk papillary thyroid carcinoma (PTC) patients with lateral lymph node metastasis (LLNM). However, the supporting evidence remains insufficient. The clinical superiority of TT versus lobectomy (LT) in this patient population remains unclear, and the optimal surgical approach for intermediate-risk PTC with LLNM continues to be debated. AIM: This meta-analysis examined the clinical superiority of TT versus LT for intermediate-risk PTC with unilateral LLNM. METHODS: This PRISMA/AMSTAR-compliant meta-analysis (PROSPERO: CRD42023410775) evaluated recurrence-free survival (RFS) in intermediate-risk PTC with unilateral LLNM. Systematic searches of PubMed, Web of Science, and Cochrane Library (2004-2024) combined Medical Subject Heading terms and title/abstract: ("papillary thyroid carcinoma" OR "papillary thyroid cancer" OR "PTC") AND ("lateral cervical lymph node metastasis" OR "lateral neck lymph node metastasis" OR "lateral lymph node metastasis" OR "lateral cervical nodal metastasis" OR "N1b") AND ("thyroidectomy" OR "total thyroidectomy" OR "lobectomy"). Two investigators independently extracted data on surgical outcomes, adjuvant RAI therapy, and RFS metrics, with quality assessed via Newcastle-Ottawa Scale. Prespecified subgroup analyses examined RAI utilization and surgical extent impa...