Factors related to central lymph node metastasis in different subregions for unilateral papillary thyroid carcinoma with clinical N0 stage
10.3760/cma.j.issn.1673-0860.2014.10.004
- VernacularTitle:临床NO单侧结节甲状腺乳头状癌Ⅵ区各亚区淋巴结转移相关因素分析
- Author:
Yabing ZHANG
1
;
Bin ZHANG
;
Hanfeng WAN
;
Dangui YAN
;
Zhengang XU
;
Pingzhang TANG
Author Information
1. 100021,中国医学科学院北京协和医学院肿瘤医院肿瘤研究所头颈外科
- Keywords:
Thyroid neoplsms;
Carcinoma,papillary;
Lymphatic metastasis;
Neck dissection
- From:
Chinese Journal of Otorhinolaryngology Head and Neck Surgery
2014;49(10):807-811
- CountryChina
- Language:Chinese
-
Abstract:
Objective To study clinicopathologic factors related to central lymph node (CLN) metastasis in different subregions for unilateral papillary thyroid carcinoma (PTC) with clinical N0.Methods A total of 145 PTC cases with clinical N0 treated in the same group of the department of head and neck surgery,Cancer Hospital,Chinese Academy of Medical Science between Jan.2011 and Jan.2014 was analysed retrospectively.Clinicopathologic factors related to CLN metastasis in different subregions were analyzed,including sex,age,tumor size,extrathyroidal extension,and multifocal tumor.Results CLN metastases existed in 57.9％ (84/145) cases and the incidences of ipsilateral paratracheal,pretracheal,and prelaryngeal metastasis were 53.8％,24.1％ and 11.3％ respectively.Right paratracheal lymph node metastasis occurred in anterior (17/38,44.7％)and posterior(12/38,31.6％) to the recurrent laryngeal nerve.Multivariate analysis indicated that extrathyroidal extension(OR =4.49,95％ CI 1.80-11.20,P =0.001) and tumor size (OR =2.17,95％ CI 1.06-4.45,P =0.034) were independent risk factors for ipsilateral paratracheal CLN metastasis ;ipsilateral paratracheal CLN metastasis(OR =2.12,95％ CI 0.08-4.60,P =0.003) was an independent risk factor for pretracheal CLN metastasis.Conclusions A high risk of CLN metastasis especially ipsilateral paratracheal metastasis exists in DTC with clinical N0.Ipsilateral paratracheal,pretracheal and prelaryngeal CLN dissection should be conducted when maximum tumor diameter more than 1 cm or extrathyroidal extension.CLN anterior and posterior to the recurrent larygeal nerve should be removed simultaneously when the ipsilateral paratracheal CLN metastasis at right side.Total thyroidectomy and contralateral paratracheal CLN dissection should be conciderded in multifocal tumor.
