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Predictive factors for central compartment lymph node metastasis in thyroid papillary microcarcinoma
Sang-Hyuk Lee1, Seung-Suk Lee, Sung-Min Jin
1Department of Otorhinolaryngology-Head and Neck Surgery, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, Seoul, Korea.
The Laryngoscope
|January 8, 2008
Summary
Predictive factors for central compartment lymph node metastasis in thyroid papillary microcarcinoma (PMC) were identified. Extracapsular spread, lateral lymph node metastasis, and tumor size greater than 5 mm are key indicators for prophylactic central compartment dissection.
Area of Science:
- Oncology
- Head and Neck Surgery
- Endocrine Surgery
Background:
- Thyroid papillary microcarcinoma (PMC) is a common thyroid malignancy.
- Nodal involvement is a critical factor in PMC prognosis and treatment.
- Understanding predictive factors for central compartment lymph node (LN) metastasis is essential for optimal surgical management.
Purpose of the Study:
- To determine the incidence of nodal involvement in PMC.
- To identify predictive factors associated with central compartment LN metastasis in PMC patients.
Main Methods:
- Retrospective chart review of 52 patients with PMC who underwent total thyroidectomy and central compartment LN dissection.
- Analysis of clinical and pathological criteria including sex, age, multifocality, extracapsular spread (ECS), lateral LN metastasis, tumor size, and tumor location.
- Univariate and multivariate analyses were employed to identify independent correlates of metastasis.
Main Results:
- Central compartment LN metastasis was detected in 31% (16/52) of patients.
- Extracapsular spread (ECS), lateral LN metastasis, and tumor size greater than 5 mm were independently associated with central compartment metastasis.
- Sex, age, tumor multifocality, and tumor location did not significantly predict central compartment LN metastasis.
Conclusions:
- Significant associations exist between ECS, lateral LN metastasis, tumor size (>5 mm), and central compartment LN metastasis in PMC.
- Prophylactic central compartment neck dissection is recommended for PMC patients with ECS, lateral LN metastasis, or tumors >5 mm.
