Predictive factors for central lymph node and lateral cervical lymph node metastases in papillary thyroid carcinoma

Area of Science:

• Oncology
• Surgical Oncology
• Endocrine Surgery

Background:

• Central lymph node metastasis (LNM) is frequent in papillary thyroid carcinoma (PTC).
• Predictors for LNM and their impact on recurrence-free survival (RFS) require further elucidation.
• Understanding these factors can optimize lymph node dissection strategies.

Purpose of the Study:

• To identify clinicopathologic factors associated with central and lateral compartment LNM in PTC.
• To determine risk factors for recurrence-free survival (RFS) in PTC patients.

Main Methods:

• Retrospective analysis of 432 PTC patients undergoing thyroidectomy and cervical lymph node dissection.
• Multivariate analysis to identify predictors of central LNM, lateral LNM, and RFS.

Main Results:

• Central lymph node metastasis (CLNM) occurred in 50% of patients, and lateral lymph node metastasis (LLNM) in 15%.
• Independent predictors for CLNM included younger age (<45), extrathyroidal invasion, vascular invasion, LLNM, and advanced TNM stage (III-IV).
• Tumor size (>1cm) and CLNM were independent predictors for LLNM. Extrathyroidal invasion and CLNM were significant factors for RFS.

Conclusions:

• Preoperative risk assessment for LNM is crucial for guiding surgical decisions.
• Prophylactic lymph node dissection is recommended for patients at high risk of CLNM.
• Close follow-up is advised for patients with high risk of RFS.