Solitary lateral neck node metastasis in papillary thyroid carcinoma

Area of Science:

• Oncology
• Surgical Oncology
• Head and Neck Surgery

Background:

• Papillary thyroid carcinoma (PTC) frequently metastasizes to regional lymph nodes.
• Patterns of lateral neck node metastasis (LNM) in PTC can vary, with solitary LNM (SLNM) occurring in some cases.
• The appropriateness of selective single-level node dissection for PTC with SLNM requires evaluation.

Purpose of the Study:

• To assess the suitability of selective single-level node dissection in PTC patients presenting with solitary lateral neck node metastasis (SLNM).
• To compare clinicopathologic characteristics between PTC patients with SLNM and multiple LNM (MLNM).

Main Methods:

• Retrospective review of 241 PTC patients undergoing total thyroidectomy with central and ipsilateral lateral neck dissection (levels II-IV).
• Patients were categorized into SLNM (n=51) and MLNM (n=190) groups.
• Clinicopathologic features were compared between the two groups.

Main Results:

• The SLNM group had a significantly smaller mean primary tumor size (1.03 cm vs. 1.35 cm) and a higher proportion of tumors ≤1 cm (60.8% vs. 38.4%).
• Patients with SLNM had a lower proportion of maximal metastatic node size ≤0.7 cm (28.9% vs. 73.3%) and less capsular invasion (62.7% vs. 83.7%).
• Age, gender ratio, and harvested node counts were similar between groups.

Conclusions:

• Selective single-level neck dissection is a potential alternative to systemic lateral neck dissection for specific PTC patients.
• This approach is suitable for PTC patients with SLNM, maximal metastatic node size ≤0.7 cm, and no extrathyroidal invasion.