Papillary thyroid microcarcinoma with and without nodal metastasis: A comparative analysis

Area of Science:

• Endocrinology
• Oncology
• Pathology

Background:

• Papillary thyroid microcarcinoma (PTMC) is frequently discovered incidentally.
• Despite small size, PTMC carries a notable risk of lymph node metastasis (LNM).
• Understanding PTMC demographics and LNM predictors is crucial for patient management.

Purpose of the Study:

• To evaluate the demographic and clinical characteristics of PTMC patients in Saudi Arabia.
• To identify factors associated with lymph node metastasis (LNM) in PTMC.
• To compare clinical differences between PTMC patients with and without LNM.

Main Methods:

• Retrospective analysis of PTMC patients undergoing surgery between 2012-2022.
• Inclusion of data from King Abdulaziz University Hospital, King Fahad Medical City, and King Abdulaziz Medical City.
• Statistical comparison of patient demographics and clinical factors based on LNM status.

Main Results:

• The overall incidence of LNM in PTMC patients was 9.17%.
• Significant risk factors for LNM included higher Bethesda class, specific pathology types, extrathyroidal extension, extracapsular extension, lymphovascular invasion, and residual tumors post-radioactive iodine therapy.
• Factors such as thyroiditis, multifocality, goiter, neural invasion, and tumor size were not significantly associated with LNM.

Conclusions:

• Higher Bethesda class, pathology type, extrathyroidal extension, extracapsular extension, lymphovascular invasion, and residual tumors after RAI treatment are strongly associated with LNM in PTMC.
• These findings aid in stratifying PTMC patients at higher risk for LNM.
• Further research may refine risk stratification and treatment strategies for PTMC.