Factors associated with occult lateral lymph node metastases in patients with clinically lymph node negative papillary thyroid carcinoma: a systematic review and meta-analysis

Yuan Fei ¹, Bin Wang ¹, Xinmin Yao ¹

⁰Center of Breast and Thyroid Surgery, Department of General Surgery, The Third People's Hospital of Chengdu, Affiliated Hospital of Southwest Jiaotong University, Chengdu, China.

Frontiers in Endocrinology +

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November 4, 2024

View abstract on PubMed

Summary

This study identified seven factors predicting occult lateral lymph node metastasis in clinically lymph node negative papillary thyroid carcinoma patients. Key predictors include male sex, younger age, larger tumor size, and extrathyroidal extension.

Area Of Science

Oncology
Surgical Oncology
Head and Neck Surgery

Background

Papillary thyroid carcinoma (PTC) is the most common thyroid malignancy.
Accurate risk stratification for clinically lymph node negative (cN0) PTC patients is crucial for appropriate management.
Identifying patients at higher risk for occult lateral lymph node metastasis (OLLNM) can guide surgical decisions and improve outcomes.

Approach

A systematic review and meta-analysis was conducted to identify factors associated with OLLNM in cN0 PTC.
Comprehensive literature searches were performed across major databases (PubMed, EMBASE, Cochrane Library, Web of Science) up to August 2022.
Pooled analysis of data from 15 eligible studies involving 8369 patients was performed to calculate odds ratios and confidence intervals.

Key Points

Seven factors were significantly associated with OLLNM in cN0 PTC patients.
These factors include male sex, age < 45 years, tumor size > 10 mm, upper pole tumor location, bilaterality, extrathyroidal extension (ETE), and increased central lymph node metastasis (CLNM).
Sensitivity and subgroup analyses confirmed the robustness of the findings, with no significant publication bias observed.

Conclusions

This meta-analysis provides valuable insights into predictors of OLLNM in cN0 PTC.
The identified factors can aid clinicians in stratifying patient risk and tailoring treatment strategies.
Further research is warranted to validate these findings in prospective studies.

Keywords:

clinically lymph node negative factor meta analysis occult lateral lymph node metastases papillary thyroid carcinoma