To analyze the clinical efficacy of prophylactic central lymph node dissection for clinical node-negative (cN0) differentiated thyroid carcinoma (DTC).

The clinical data of 165 patients with cN0 DTC who received surgical treatment between January 2022 and May 2024 were retrospectively analyzed. Patients were divided into the observation group (n=93), receiving thyroid lobectomy combined with prophylactic central lymph node dissection) and the control group (n=72), receiving thyroid lobectomy alone). Statistical analysis was performed using SPSS 23.0 software. Measurement data including perioperative indicators and parathyroid gland function parameters were expressed as (mean ± standard） deviation and compared between groups via the t test. Enumeration data such as postoperative complication rates and recurrence rates were presented as [cases (%)], and intergroup comparisons were conducted with the chi-square test. The Kaplan-Meier method was applied for survival analysis, and the Log-Rank test was used to verify the validity of the survival model. A P value less than 0.05 was defined as statistically significant.

The observation group had longer operative duration and greater intraoperative blood loss than the control group (P<0.05). No significant difference in hospital stay was detected between the two groups (P>0.05). On postoperative day 7, the levels of parathyroid hormone (PTH), serum calcium, CD4⁺ and CD8⁺ lymphocytes in the observation group were lower than those in the control group (P<0.05). There was no statistically significant intergroup difference in the overall incidence of postoperative complications (P>0.05). The postoperative recurrence rate was lower and progression-free survival was longer in the observation group relative to the control group (P<0.05).

Compared with thyroid lobectomy alone, thyroid lobectomy combined with prophylactic central lymph node dissection for cN0 DTC prolongs operative time, increases intraoperative blood loss and impairs immune function. However, this combined procedure does not raise the incidence of postoperative complications, and can reduce tumor recurrence rate and extend patients' progression-free survival.