Risk factors and distribution pattern of lateral lymph node recurrence after central neck dissection for cN1a...

Area of Science:

• Oncology
• Surgical Oncology
• Head and Neck Surgery

Background:

• The optimal extent of lateral neck dissection (LND) for cN1a papillary thyroid carcinoma (PTC) is debated.
• Understanding lateral lymph node recurrence (LLNR) patterns is crucial for treatment planning.

Purpose of the Study:

• To identify predictors of LLNR after central neck dissection in cN1a PTC patients.
• To analyze the distribution pattern of LLNR in the lateral neck.

Main Methods:

• Retrospective review of cN1a PTC patients who underwent initial central neck dissection.
• Median follow-up of 6.8 years with reoperation for confirmed LLNR.
• Multivariate analysis to identify risk factors and record metastatic status of lateral lymph node levels.

Main Results:

• 18.7% of 310 patients experienced LLNR.
• Independent predictors included tumor diameter, pathological T4 stage, central lymph node count, pTNM stage, extrathyroidal extension, and I131 treatment.
• LLNR most frequently occurred at levels III (65.5%) and IV (51.7%).

Conclusions:

• Tumor diameter ≥2 cm, pathological T4 stage, ≥3 involved central lymph nodes, pTNM stage III-IV, extrathyroidal extension, and lack of I131 treatment predict LLNR in cN1a PTC.
• LLNR is more probable in lateral neck levels III and IV.