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Transoral Robotic Total Thyroidectomy and Bilateral Central Regional Lymph Node Dissection for Papillary Thyroid Carcinoma
Published on: September 15, 2023
822
Risk factors for central lymph node metastasis in patients with papillary thyroid carcinoma: a retrospective study
Jiachen Du1, Qing Yang1, Yixuan Sun2
1Department of Breast and Thyroid Surgery, Shandong Provincial Hospital, Shandong First Medical University, Jinan, Shandong, China.
Frontiers in Endocrinology
|December 4, 2023
Summary
Identifying risk factors for central lymph node metastasis (CLNM) in papillary thyroid carcinoma (PTC) is crucial for effective treatment. Age, BMI, tumor size, capsular invasion, and BRAF V600E mutation are key predictors of CLNM in PTC patients.
Area of Science:
- Endocrinology
- Oncology
- Surgical Oncology
Background:
- Thyroid cancer, particularly papillary thyroid carcinoma (PTC), is a growing global health concern.
- Central lymph node metastasis (CLNM) is common in PTC and linked to recurrence, yet preoperative assessment remains challenging.
Purpose of the Study:
- To identify clinicopathological risk factors for CLNM in PTC patients.
- To develop a predictive model for CLNM to guide treatment decisions.
Main Methods:
- Retrospective analysis of 400 PTC patients' data (2018-2022).
- Inclusion of clinicopathological information, thyroid function, BRAF V600E mutation, Hashimoto's thyroiditis, and capsular invasion.
- Application of univariate, multivariate logistic, and Cox regression analyses.
Main Results:
- Age >45, BMI ≥25, tumor size ≥1 cm, capsular invasion, and BRAF V600E mutation significantly increased CLNM risk.
- A nomogram demonstrated strong discriminative ability (AUC 0.791 training, 0.765 validation).
- For microcarcinoma with BRAF V600E mutation, therapeutic central neck dissection improved disease-free survival over prophylactic.
Conclusions:
- Age, BMI, tumor size, capsular invasion, and BRAF V600E mutation are key predictors of CLNM in PTC.
- BRAF V600E mutation status is critical for guiding central lymph node dissection in clinically nodal-negative microcarcinoma.
