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Related Experiment Video

Updated: Jun 13, 2025

Transoral Robotic Total Thyroidectomy and Bilateral Central Regional Lymph Node Dissection for Papillary Thyroid Carcinoma
04:01

Transoral Robotic Total Thyroidectomy and Bilateral Central Regional Lymph Node Dissection for Papillary Thyroid Carcinoma

Published on: September 15, 2023

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Construction and validation of nomograms to predict central lymph node metastasis in clinical node-negative

Longqing Hu1, Bei Qian1, Junlin Zhu1

  • 1Department of Thyroid and Breast Surgery, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, 1277 Jiefang Avenue, Wuhan, 430022, China.

Scientific Reports
|January 21, 2025
PubMed
Summary

This study developed two nomograms to predict central lymph node metastasis in unilateral papillary thyroid carcinoma patients without clinical lymph node metastasis. These tools aid in surgical decisions by stratifying patient risk for ipsilateral and contralateral lymph node spread.

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Area of Science:

  • Oncology
  • Surgical Oncology
  • Head and Neck Surgery

Background:

  • Neck lymph node dissection scope is debated for unilateral papillary thyroid carcinoma (UPTC) with clinically node-negative (cN0) status.
  • Accurate prediction of central lymph node metastasis (CLNM) is crucial for optimizing surgical strategies in UPTC patients.

Purpose of the Study:

  • To develop and validate predictive models for CLNM in cN0 UPTC patients.
  • To utilize preoperative data and intraoperative frozen pathology for risk stratification.
  • To aid surgical decision-making by predicting ipsilateral and contralateral CLNM probabilities.

Main Methods:

  • Retrospective analysis of 1928 UPTC patients from 2010-2020.
  • Data split into training (70%) and validation (30%) sets.
  • Univariate and multivariate logistic regression to identify risk factors for CLNM.

Main Results:

  • Identified six risk factors for ipsilateral CLNM and seven for contralateral CLNM in cN0 UPTC patients.
  • Developed two nomograms with C-indexes of 0.746 (ipsilateral) and 0.712 (contralateral).
  • Nomograms demonstrated good calibration and clinical utility.

Conclusions:

  • The developed nomograms effectively predict CLNM in cN0 UPTC patients.
  • These tools enable personalized risk assessment and informed surgical planning.
  • Nomograms can guide decisions regarding the extent of neck lymph node dissection.