Central lymph node metastasis in cN0 papillary thyroid carcinoma.

Area of Science:

• Oncology
• Surgical Oncology
• Endocrine Surgery

Background:

• Papillary thyroid carcinoma (PTC) is the most common type of thyroid cancer.
• Central lymph node (CLN) metastasis is a frequent occurrence in PTC and can impact prognosis.
• Understanding predictive factors for CLN metastasis is crucial for effective patient management.

Purpose of the Study:

• To identify factors predicting central lymph node (CLN) metastasis in papillary thyroid carcinoma (PTC).
• To examine the relationship between the number of metastatic CLN and recurrence/metastasis risk factors.

Main Methods:

• Retrospective review of PTC patients undergoing thyroidectomy and ipsilateral CLN dissection.
• Patients categorized into three groups based on the number of metastatic CLN (0, 1-2, ≥3).
• Statistical analysis including univariate and multivariate analyses to identify risk factors.

Main Results:

• Occult ipsilateral CLN metastasis observed in 34.2% of patients.
• Younger age (<45 years), larger tumor size (≥1 cm), and extrathyroid extension were associated with higher metastasis rates.
• Tumor size and age were independent risk factors; tumor size increased with metastatic CLN count, while age decreased.

Conclusions:

• Maximal carcinoma diameter ≥1 cm and younger age are linked to increased ipsilateral CLN metastasis in unilateral PTC.
• Prophylactic ipsilateral CLN dissection may be beneficial for these patients.
• The number of metastatic CLN shows a negative association with prognostic factors like age, tumor size, and extrathyroid extension.