Subclinical Central Lymph Node Metastasis in Papillary Thyroid Microcarcinoma Evaluated as cT1aN0 by Preoperative Imaging Study.
10.11106/jkta.2013.6.2.121
- Author:
Seung Tae KIM
1
;
Bong Kwon CHEON
;
Hyoung Shin LEE
;
Sung Won KIM
;
Hyo Sang PARK
;
Kang Dae LEE
Author Information
1. Department of Otolaryngology-Head and Neck Surgery, Kosin University Gospel Hospital, Busan, Korea. kdlee@gmail.com
- Publication Type:Original Article
- Keywords:
Papillary thyroid microcarcinoma;
Neck dissection
- MeSH:
Carcinoma, Papillary;
Humans;
Lymph Nodes*;
Multivariate Analysis;
Neck Dissection;
Neoplasm Metastasis*;
Pathology;
Prevalence;
Prognosis;
Retrospective Studies;
Thyroid Gland*;
Thyroid Neoplasms;
Thyroidectomy
- From:Journal of Korean Thyroid Association
2013;6(2):121-125
- CountryRepublic of Korea
- Language:English
-
Abstract:
BACKGROUND AND OBJECTIVES: Papillary thyroid microcarcinoma (PTMC) generally has a highly favorable prognosis, however reports show a 30-65% prevalence of subclinical central lymph node metastasis. Therefore, the role of elective central neck dissection in PTMC treatment remains controversial. Our study focused on preoperative features of clinically lymph node negative and intracapsular (cT1aN0) PTMC and the correlation of these features with subclinical central lymph node metastasis. MATERIALS AND METHODS: Of 584 PTC patients who underwent thyroidectomy at the Kosin University Gospel Hospital from January 2009 to July 2011, 219 patients with cT1aN0 PTMC were reviewed retrospectively. Pathologic results were reviewed and various clinicopathologic prognostic factors were investigated. RESULTS: Postoperative pathology report revealed capsular invasion of primary tumor in 77 patients (35.2%) and subclinical central lymph node metastasis in 62 patients (28.3%). Tumor of the isthmic location was an independent predictor of subclinical central lymph node metastasis by multivariate analysis while multifocality showed borderline significance. The presence of extrathyroidal extension (ETE), multifocality, and cervical lymph node metastasis were significantly related to PTMC of isthmus. Seven of the 14 subjects with PTMC of the isthmus (50%) had pretracheal lymph node metastasis showing significant correlation (p=0.001). CONCLUSION: Despite the absence of ETE and lymph node metastasis in the preoperative imaging studies, higher risk of subclinical central lymph node metastasis should be considered in PTMC with multifocality and tumor of the isthmus.
