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Updated: Oct 3, 2025
Transoral Robotic Total Thyroidectomy and Bilateral Central Regional Lymph Node Dissection for Papillary Thyroid Carcinoma
Published on: September 15, 2023
Risk factors for lateral lymph node metastasis of papillary thyroid carcinoma in children
Duy Quoc Ngo1, Duong The Le2, Quy Xuan Ngo2
1Department of Head and Neck Surgery, Vietnam National Cancer Hospital, 30 Cau Buou Street, Thanh Tri District, Hanoi, Vietnam; Hanoi Medical University, 01 Ton That Tung Street, Dong Da District, Hanoi, Vietnam.
Insights
Pediatric papillary thyroid cancer (PTC) patients frequently develop lateral lymph node metastases (LNM). Multifocality, tumor size, extrathyroidal extension, and central LNM are key risk factors for lateral LNM in these young patients.
Area of Science:
- Pediatric Oncology
- Head and Neck Surgery
- Endocrinology
Background:
- Lateral cervical lymph node metastases (LNM) are a significant negative prognostic indicator in pediatric patients diagnosed with papillary thyroid cancer (PTC).
- Identifying risk factors for lateral LNM is crucial for improving treatment strategies and patient outcomes in this population.
Purpose of the Study:
- To identify and analyze the risk factors associated with the development of lateral cervical lymph node metastases in pediatric patients with papillary thyroid cancer.
Main Methods:
- A retrospective study was conducted involving 48 pediatric patients with papillary thyroid cancer.
- All patients underwent total thyroidectomy and central cervical lymphadenectomy between 2016 and 2020.
- Data analysis included univariate analysis to identify risk factors for lateral LNM.
Main Results:
- The study found that 62.5% of pediatric PTC patients presented with lateral LNM (N1b).
- Significant risk factors for lateral LNM included older age, male gender, tumor size greater than 10 mm, tumor multifocality, extrathyroidal extension, and the presence of central LNM.
- Three patients (6.3%) had lung metastases at initial presentation.
Conclusions:
- Multifocality, maximum tumor diameter, extrathyroidal extension, and central lymph node metastases were confirmed as independent risk factors for lateral LNM in pediatric PTC.
- These findings highlight the importance of considering these factors in the risk stratification and management of pediatric papillary thyroid cancer.
Introduction:
Lateral cervical lymph node metastases (LNM) for pediatric patients with papillary thyroid cancer (PTC) is a poor prognostic factor. We aimed to identify risk factors for lateral LNM.
Methods:
This retrospective study had included 48 pediatric patients with papillary thyroid cancer underwent total thyroidectomy and central cervical lymphadenectomy at K hospital from 2016 to 2020.
Results:
The number of patients in each T stage was as follows: 24 (50.0%) in stage 1, 9 (18.7%) in Stage 2, 8 (16.7%) in Stage 3, and 7 (14.6%) in Stage 4. Most of the patients had LNM with N1a and N1b rates of 83.3% and 62.5%, respectively. Lung metastases were observed at presentation in three patients (6.3%). Univariate analysis revealed that age (p = 0.021), male (p = 0.011), tumor size > 10 mm (p = 0.002), multifocality (p < 0.001), extrathyroidal extension (p = 0.001) and central LNM (p < 0.001) were factors that increase the risk of metastasis to lateral LNM.
Conclusion:
Approximately 62.5% of pediatric patients with PTC exhibited lateral LNM at the time of diagnosis. Our study confirmed that multifocality, maximum tumor diameter, extrathyroidal extension and central LNM were independent risk factors for lateral LNM in pediatric PTC.
Level Of Evidence:
Level IV.
