Predictive factors of central lymph node metastasis in papillary thyroid carcinoma.
10.4174/astr.2015.88.2.63
- Author:
Byong Hyon AHN
1
;
Je Ryong KIM
;
Ho Chul JEONG
;
Jin Sun LEE
;
Eil Sung CHANG
;
Yong Hun KIM
Author Information
1. Department of Surgery, Chungnam National University College of Medicine, Daejeon, Korea. kimjr@cnu.ac.kr
- Publication Type:Original Article
- Keywords:
Lymph node;
Metastasis;
Papillary thyroid cancer
- MeSH:
Humans;
Incidence;
Lymph Nodes*;
Neoplasm Metastasis*;
Odds Ratio;
Prospective Studies;
Risk Factors;
Thyroid Neoplasms*;
Thyroidectomy
- From:Annals of Surgical Treatment and Research
2015;88(2):63-68
- CountryRepublic of Korea
- Language:English
-
Abstract:
PURPOSE: The aim of this study was to evaluate the correlation between central lymph node (CLN) metastasis and clinicopathologic characteristics of papillary thyroid cancer (PTC). In addition, we investigated the incidence and risk factors for contralateral CLN metastasis in unilateral PTC. This study suggests the appropriate surgical extent for CLN dissection. METHODS: A prospective study of 500 patients with PTC who underwent total thyroidectomy and prophylactic bilateral CLN dissection was conducted. RESULTS: Of 500 patients, 255 had CLN metastases. The rate of CLN metastasis was considerably higher in cases of younger patients (<45 years old) (P < 0.001; odds ratio [OR], 2.357) and of a maximal tumor size greater than 1 cm (P < 0.001; OR, 3.165). Ipsilateral CLN metastasis was detected in 83.1% of cases (133/160) of unilateral PTC, only contralateral CLN metastases in 3.7% of cases (6/160), and bilateral CLN metastases in 13.1% of cases (21/160). The rate of contralateral CLN metastasis was considerably higher in cases of PTC with a large tumor size (> or =1 cm) (P = 0.019; OR, 4.440) and with ipsilateral CLN metastasis (P = 0.047; OR, 2.613). CONCLUSION: Younger age (<45 years old) and maximal tumor size greater than 1 cm were independent risk factors for CLN metastasis. Maximal tumor size greater than 1 cm and presence of ipsilateral CLN macrometastasis were independent risk factors for contralateral CLN metastasis. Therefore, both CLN dissections should be considered for unilateral PTC with a maximal tumor size greater than 1 cm or presence of ipsilateral CLN macrometastasis.
