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Predictive Factors for Lymph Node Metastasis in Papillary Thyroid Microcarcinoma.

Seo Ki Kim1, Inhye Park1, Jung-Woo Woo2

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Predictors for lymph node metastasis in papillary thyroid microcarcinoma (PTMC) were identified. Male gender, larger tumors, and extrathyroidal extension increase metastasis risk, aiding in locoregional recurrence assessment.

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Area of Science:

  • Endocrinology
  • Oncology
  • Surgical Pathology

Background:

  • Lymph node (LN) metastasis is a key predictor of locoregional recurrence (LRR) in papillary thyroid microcarcinoma (PTMC).
  • Identifying predictors of LN metastasis is crucial for managing PTMC and preventing recurrence.

Purpose of the Study:

  • To identify independent predictors of central and lateral lymph node metastasis in patients with PTMC.
  • To inform perioperative evaluation and risk stratification for PTMC patients.

Main Methods:

  • Retrospective review of 5656 PTMC patients undergoing total thyroidectomy and neck dissection.
  • Statistical analysis to determine independent predictors of central lymph node metastasis (CLNM) and lateral lymph node metastasis (LLNM).

Main Results:

  • Male gender, conventional variant, tumor size >0.5 cm, multiplicity, bilaterality, and extrathyroidal extension (ETE) independently predicted higher CLNM prevalence.
  • Male gender, tumor size >0.5 cm, multiplicity, ETE, and CLNM independently predicted higher LLNM prevalence.
  • Age and chronic lymphocytic thyroiditis were associated with lower CLNM prevalence; age was associated with lower LLNM prevalence.

Conclusions:

  • Specific patient and tumor characteristics are significant predictors of lymph node metastasis in PTMC.
  • Perioperative evaluation should consider these predictors to guide management and assess LRR risk.