对于临床无淋巴结转移（cN0）的乳头状甲状腺癌（PTC）患者进行预防性中央颈淋巴结切除（pCND）的推荐意见并不相同。本次荟萃分析旨在比较西方国家和中国之间的pCND与全甲状腺切除术（TT）的效果。通过搜索PubMed、EMBASE和Cochrane图书馆等电子数据库，收集了截至2022年8月发表的研究。采用随机效应模型汇总颈部淋巴结转移（LNMs）的发生率、局部区域复发率（LRRs）和术后并发症。并进行了基于不同国家和地区的亚组分析。共分析了18个涉及5,346例患者的研究。在西方国家的亚组中，接受pCND和TT的患者LRR率明显较低（69/1,804, 3.82% vs. 139/2,541, 5.47%；比值比（OR）= 0.56；95%置信区间（CI）0.37-0.85），且暂时性甲状旁腺功能减退（HPT）比率较高（316/1,279, 24.71% vs. 194/1,467, 13.22%；OR = 2.23；95% CI 1.61-3.08），而在永久性HPT和暂时性与永久性喉返神经（RLN）损伤方面无统计学显著差异。在中国亚组中，pCND与TT组的暂时性HPT（87/374, 23.26% vs. 36/324, 11.11%；OR = 2.24；95% CI 1.32-3.81）和永久性HPT（21/374, 5.61% vs. 4/324, 1.23%；OR = 3.58；95% CI = 1.24-10.37）的发生率明显较高，而在LRR率和暂时性与永久性RLN损伤率方面则无显著差异。与cN0 PTC患者的单纯TT相比，在欧洲、美国和澳大利亚进行的研究中，pCND与TT相比具有显著较低的LRR率，同时存在较高的暂时性HPT率；然而，在中国进行的研究中，pCND与TT相比在降低LRR率方面无显著差异，但暂时性和永久性HPT率显著增加。需要进行更多基于人群的研究结果来支持甲状腺癌的精准医疗。https://www.crd.york.ac.uk/PROSPERO/，识别码CRD42022358546.Copyright © 2023 Yang, Han, Min, Chen, Chen, Xiang, Liao, Feng, Hu and Yin.

Recommendations for the performance of prophylactic central neck dissection (pCND) in patients with clinically node-uninvolved (cN0) papillary thyroid carcinoma (PTC) are not the same. This meta-analysis set out to compare the effectiveness of pCND with total thyroidectomy (TT) in different countries and regions, mainly between western countries and China.The electronic databases PubMed, EMBASE, and Cochrane Library were searched for studies published until August 2022. The incidence rate of cervical lymph node metastases (LNMs), locoregional recurrences (LRRs), and postoperative complications were pooled by a random-effects model. Subgroup analyses based on different countries and regions were performed.Eighteen studies involving 5,346 patients were analyzed. In the subgroup of western countries, patients undergoing pCND with TT had a significantly lower LRR rate [69/1,804, 3.82% vs. 139/2,541, 5.47%; odds ratio (OR) = 0.56; 95% CI 0.37-0.85] and a higher rate of temporary hypoparathyroidism (HPT) (316/1,279, 24.71% vs. 194/1,467, 13.22%; OR = 2.23; 95% CI 1.61-3.08) than that of the TT alone group, while no statistically significant difference was found in the rate of permanent HPT and temporary and permanent recurrent laryngeal nerve (RLN) injury. In the Chinese subgroup, the pCND with TT group had a significantly higher incidence rate of both temporary HPT (87/374, 23.26% vs. 36/324, 11.11%; OR = 2.24; 95% CI 1.32-3.81) and permanent HPT (21/374, 5.61% vs. 4/324, 1.23%; OR = 3.58; 95% CI = 1.24-10.37) than that of the TT alone group, while no significant difference was detected in the rate of LRR and temporary and permanent RLN injury.Compared with the TT alone for cN0 PTC patients, pCND with TT had a significantly lower LRR rate while having a higher temporary HPT rate in Europe, America, and Australia; however, it showed no significant difference in decreasing LRR rate while having a significantly raised rate of temporary and permanent HPT in China. More population-based results are required to advocate precision medicine in PTC.https://www.crd.york.ac.uk/PROSPERO/, identifier CRD42022358546.Copyright © 2023 Yang, Han, Min, Chen, Chen, Xiang, Liao, Feng, Hu and Yin.