[Central compartment lymph node metastasis in cN0 papillary thyroid carcinoma]

Area of Science:

• Oncology
• Surgical Oncology
• Head and Neck Surgery

Background:

• Papillary thyroid carcinoma (PTC) is the most common type of thyroid cancer.
• Accurate staging of lymph node metastasis is crucial for treatment planning in PTC.
• Central compartment lymph node (level VI) metastasis in clinically node-negative (cN0) PTC requires further investigation.

Purpose of the Study:

• To determine the incidence of level VI lymph node metastasis in cN0 PTC patients.
• To identify independent predictive factors for level VI metastasis in cN0 PTC.
• To evaluate the necessity of selective neck dissection for these patients.

Main Methods:

• Retrospective analysis of 108 cN0 PTC patients who underwent level VI neck dissection.
• Statistical analysis including univariate (χ² test) and multivariate (Logistic regression) methods.
• Kaplan-Meier analysis for survival and recurrence rates.

Main Results:

• A high metastasis rate of 59.2% was observed in level VI lymph nodes.
• Independent predictive factors for level VI metastasis included age < 45, tumor size > 3 cm, and extracapsular spread.
• Low rates of transient (nerve palsy, hypoparathyroidism) and permanent (hypoparathyroidism) complications were reported.

Conclusions:

• Level VI lymph node metastasis is frequent in cN0 PTC.
• Selective neck dissection is a necessary procedure for cN0 PTC patients.
• Predictive factors can help stratify patients for central compartment lymph node dissection.