Central Compartment Lymph Nodes Have Distinct Metastatic Patterns in Different Age Groups.

Area of Science:

• Oncology
• Surgical Pathology
• Medical Diagnostics

Background:

• Central compartment lymph node metastasis (CLNM) is a key indicator of papillary thyroid carcinoma (PTC) aggressiveness and prognosis.
• Understanding age-specific CLNM patterns is crucial for accurate staging and treatment planning.

Purpose of the Study:

• To develop a predictive nomogram for CLNM in PTC patients.
• To identify distinct risk factors for CLNM across different age groups.

Main Methods:

• Analysis of 907 PTC patients diagnosed between August 2014 and December 2018.
• Multivariate logistic regression was employed to identify independent risk factors for CLNM.
• A nomogram was constructed based on the regression analysis results.

Main Results:

• Patients were stratified into two groups: <45 years and ≥45 years.
• In younger patients (<45), risk factors included large tumor size, extra-thyroid extension, and high thyroglobulin levels; Hashimoto's thyroiditis was protective.
• In older patients (≥45), risk factors included large tumor size, extra-thyroid extension, unclear margin, and male gender.
• Predictive model AUCs were 0.729 for <45 years and 0.668 for ≥45 years.

Conclusions:

• CLNM patterns in PTC exhibit significant differences based on patient age.
• A user-friendly predictive model incorporating age-specific risk factors for CLNM has been established.
• This model can aid in the clinical evaluation and risk stratification of PTC patients.