[Risk Factors for central lymph node metastasis in 1 988 papillary thyroid microcarcinoma patients]

Area of Science:

• Oncology
• Head and Neck Surgery
• Thyroid Cancer Research

Background:

• Papillary thyroid microcarcinoma (PTMC) is the smallest form of papillary thyroid cancer.
• Central lymph node metastasis is a common occurrence in PTMC, influencing treatment strategies and prognosis.
• Identifying risk factors for metastasis is crucial for personalized management of PTMC patients.

Purpose of the Study:

• To identify clinical and pathological risk factors associated with neck central lymph node metastasis in patients diagnosed with PTMC.
• To provide data that can guide more tailored treatment and follow-up protocols for PTMC.

Main Methods:

• A retrospective study analyzing clinical and pathological data from 1988 PTMC patients diagnosed between January 2010 and March 2016.
• Statistical analyses, including Chi-square tests and multivariate logistic regression, were employed to determine significant risk factors.

Main Results:

• Neck central lymph node metastasis was observed in 34.9% of the studied PTMC patients.
• Significant correlations with metastasis were found for age <45 years, male gender, multifocality, bilaterality, tumor size >5 mm, capsular invasion, and extrathyroidal extension.
• Independent predictors of metastasis included male gender, age <45 years, tumor size >5 mm, capsular invasion, and extrathyroidal extension. For solitary tumors, lower third thyroid location was a significant risk factor.

Conclusions:

• Patients with PTMC exhibiting unfavorable features such as male gender, younger age, larger tumor size, capsular invasion, extrathyroidal extension, or unifocal tumors in the lower third of the thyroid lobe are at increased risk of neck central lymph node metastasis.
• Consideration of more aggressive treatment or intensified follow-up is recommended for these high-risk PTMC patients.