Factors related to contralateral central lymph node metastasis in clinically node-nega-tive papillary thyroid carcinoma
10.3969/j.issn.1000-8179.2017.01.193
- VernacularTitle:cN0甲状腺乳头状癌对侧中央区淋巴结转移相关因素的探讨
- Author:
Wei HE
;
Xinliang SU
;
Kainan WU
;
Jing ZHOU
;
Daixing HU
;
Yijia CAO
;
Yu MAO
;
Haoyu REN
- Keywords:
papillary thyroid carcinoma;
contralateral central lymph nodes;
prelaryngeal lymph nodes;
central lymph node dissection
- From:
Chinese Journal of Clinical Oncology
2017;44(1):41-45
- CountryChina
- Language:Chinese
-
Abstract:
Objective:To analyze the factors related to metastasis of contralateral central lymph node (CLN) in cN0 papillary thyroid car-cinoma (PTC) and discuss the indications for CLN dissection. Methods:We enrolled 149 unilateral PTC patients who underwent total thyroidectomy and prophylactic bilateral (CLN) dissection. This work analyzed the relationship of gender, age, extrathyroidal extension, multifocality, thyroiditis, ipsilateral central lymph nodes, and prelaryngeal lymph node with CLNs. Results:The rates of metastasis to ip-silateral and contralateral central compartments were 73.2%and 23.5%, respectively. In univariate analysis, gender, age, tumor size, multifocality, and thyroiditis were not important in predicting contralateral central compartment lymph node metastasis (P=0.792, 0.097, 0.531, 0.269, and 1.000, respectively);by contrast, extrathyroidal extension (P=0.017), prelaryngeal lymph nodes (P=0.006), and ipsilateral CLNs (P<0.001) are related to CLN metastasis. However, multivariate analysis showed that ipsilateral central metastasis was an independent risk factor for lymph node metastasis in the contralateral central region when the number of ipsilateral central metas-tases is≥3 (P=0.010). Conclusion:Extracapsular invasion, prelaryngeal lymph nodes, and ipsilateral CLN influence the metastases of CLN. Bilateral CLN dissection should be performed when the number of ipsilateral central metastases is≥3 and there is merger of ex-tra-laryngeal lymph nodes or capsule invasion.