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Updated: Dec 25, 2025
Transoral Robotic Total Thyroidectomy and Bilateral Central Regional Lymph Node Dissection for Papillary Thyroid Carcinoma
Published on: September 15, 2023
Pediatric thyroid cancer: Risk factors for central lymph node metastasis in patients with cN0 papillary carcinoma
Duy Quoc Ngo1, Quy Xuan Ngo1, Quang Van Le2
1Department of Head and Neck Surgery, Vietnam National Cancer Hospital, 30 Cau Buou Street, Thanh Tri District, Hanoi, Viet Nam.
Insights
Central lymph node metastasis (CLN) is common (75%) in pediatric papillary thyroid cancer (PTC) patients without lymph node involvement. Younger age, larger tumors, multifocality, and extrathyroidal extension are key predictors.
Area of Science:
- Pediatric Oncology
- Surgical Oncology
- Head and Neck Cancer
Background:
- Prophylactic central neck dissection (CND) for pediatric papillary thyroid cancer (PTC) remains controversial.
- Identifying predictors of central lymph node metastasis (CLN) is crucial for treatment decisions.
Purpose of the Study:
- To determine the incidence of CLN metastasis in pediatric patients with clinically node-negative (cN0) PTC.
- To identify predictive parameters for CLN metastasis in this population.
Main Methods:
- Retrospective study of 32 pediatric patients with cN0 PTC.
- Patients underwent total thyroidectomy and prophylactic CND between 2015 and 2019.
Main Results:
- A high proportion (75.0%) of patients had CLN metastasis.
- Factors associated with CLN metastasis included younger age (≤15 years), tumor size >1 cm, multifocality, and extrathyroidal extension.
- Multivariate analysis confirmed these as independent risk factors.
Conclusions:
- Central lymph node metastasis is frequent in cN0 pediatric PTC.
- Younger age, larger tumor size, multifocality, and extrathyroidal extension are significant risk factors for CLN metastasis.
Introduction:
Prophylactic central neck node dissection (CND) for pediatric patients with papillary thyroid cancer (PTC) is still controversial. We aimed to identify the incidence and the predictive parameters of the central lymph node metastasis (CLN) in pediatric patients with cN0 PTC.
Methods:
This retrospective study had included 32 pediatric patients with cN0 PTC who underwent total thyroidectomy and prophylactic CND from 2015 to 2019.
Results:
The proportion of CLN metastasis was 75.0%. Univariate logistic regression demonstrated that CLN metastasis was associated with age (≤15 years; p = 0.028), tumour size > 1 cm (p = 0.008), multifocality (p = 0.028) and external extension (p = 0.041) Multivariate logistic regression revealed that age (≤15 years), multifocality, tumour size (>1 cm) and external extension were independent risk factors of CLN metastasis in pediatric patients.
Conclusions:
In summary, central lymph node metastasis occurred in 75% of cN0 pediatric patient and were more common in larger tumour size (>1 cm), multifocal tumours, extrathyroidal extension, and younger age.
