A Prediction Model for Contralateral Central Neck Lymph Node Metastases in Unilateral Papillary Thyroid Cancer

Area of Science:

• Oncology
• Surgical Oncology
• Diagnostic Imaging

Background:

• Papillary thyroid carcinoma (PTC) recurrence, often due to contralateral central lymph node metastases (con-CLNM), poses significant health challenges.
• Accurate assessment of con-CLNM in unilateral PTC (uni-PTC) is currently limited, impacting treatment strategies.

Purpose of the Study:

• To identify independent risk factors for con-CLNM in uni-PTC patients.
• To develop and validate a predictive nomogram for con-CLNM in uni-PTC.

Main Methods:

• A cohort of 250 uni-PTC patients undergoing total thyroidectomy and bilateral central lymph node dissection was analyzed.
• Clinical, sonographic, and pathological data were compared between patients with and without con-CLNM.
• A nomogram was constructed using identified independent predictors.

Main Results:

• Male sex, absence of Hashimoto's thyroiditis, capsular invasion, ipsilateral lateral lymph node metastases, and a high ratio of ipsilateral central lymph node metastases (≥0.16) were independent predictors of con-CLNM.
• The developed preoperative nomogram demonstrated good predictive discrimination (C-index 0.881) and calibration.

Conclusions:

• The study provides a validated tool for quantitatively predicting con-CLNM in uni-PTC patients.
• This nomogram can assist surgeons in evaluating nodal status and tailoring central lymph node dissection strategies.