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Transoral Robotic Total Thyroidectomy and Bilateral Central Regional Lymph Node Dissection for Papillary Thyroid Carcinoma
Published on: September 15, 2023
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Risk Factors for Central Neck Lymph Node Metastases in Micro- Versus Macro- Clinically Node Negative Papillary
Luca Sessa1, Celestino Pio Lombardi1, Carmela De Crea2
1U.O.C. Chirurgia Endocrina e Metabolica, Fondazione Policlinico Universitario A. Gemelli, Università Cattolica del Sacro Cuore, Rome, Italy.
World Journal of Surgery
|December 15, 2017
Summary
Tumor size does not predict central lymph node metastases (CNM) in papillary thyroid carcinoma (PTC). Extracapsular invasion and multifocality are key risk factors for CNM in PTC patients.
Area of Science:
- Oncology
- Surgical Pathology
- Head and Neck Surgery
Background:
- Papillary thyroid carcinoma (PTC) risk stratification for occult central lymph node metastases (CNM) is crucial.
- Tumor size has been considered a potential predictor for CNM in PTC.
Purpose of the Study:
- To evaluate clinical and pathological factors identifying patients at higher risk of occult CNM in papillary thyroid carcinoma.
- To compare risk factors for CNM in micro-PTC versus macro-PTC.
Main Methods:
- Prospective study of 186 patients with clinically node-negative (cN0), unifocal PTC undergoing total thyroidectomy and bilateral central neck dissection.
- Analysis of clinicopathological factors, including tumor size, extracapsular invasion, multifocality, and angioinvasion, as predictors of CNM.
Main Results:
- No significant difference in CNM rates was observed across various tumor size cutoffs (≤20 mm, ≤10 mm, ≤5 mm).
- Extracapsular invasion and multifocality were independent risk factors for CNM in the overall PTC cohort.
- Specific risk factors for CNM differed between micro-PTC (extracapsular invasion, multifocality) and macro-PTC (angioinvasion, classic PTC histology).
Conclusions:
- Tumor size is not a reliable predictor of occult CNM in clinically node-negative, unifocal papillary thyroid carcinoma.
- Risk factors for CNM vary between micro-PTC and macro-PTC, highlighting the need for tailored risk assessment.
