[Clinical research strategy for cN0 thyroid papillary carcinoma central lymph node dissection]

Area of Science:

• Endocrinology
• Surgical Oncology
• Head and Neck Surgery

Background:

• Papillary thyroid carcinoma (PTC) is the most common type of thyroid cancer.
• Accurate assessment of central lymph node metastasis is crucial for treatment planning in cN0 PTC patients.

Purpose of the Study:

• To investigate the pattern of central lymph node metastasis in clinically node-negative (cN0) single papillary thyroid carcinoma.
• To provide evidence for the necessity and extent of central lymph node dissection.

Main Methods:

• Thyroidectomy and bilateral central lymph node dissection were performed on 150 cN0 single PTC patients.
• Central lymph nodes were divided into four regions for analysis: ipsilateral superior, ipsilateral inferior, contralateral superior, and contralateral inferior.
• Factors influencing lymph node metastasis in these regions were analyzed.

Main Results:

• The highest lymph node metastasis rate was observed in the lower ipsilateral central area (56.7%).
• The lower contralateral central area showed a metastasis rate of 28.0%, while the ipsilateral superior area had 17.3%.
• No metastasis was found in the contralateral superior central area. Thyroid capsule invasion and age ≥ 45 were independent risk factors for metastasis in specific regions.

Conclusions:

• The contralateral superior central lymph node region in cN0 single PTC patients does not require routine dissection.
• Findings support tailored central lymph node dissection strategies based on metastasis patterns.