Risk factors for distant metastasis in papillary thyroid carcinoma: Association with lateral lymph node metastasis

Area of Science:

• Oncology
• Head and Neck Surgery
• Endocrinology

Background:

• Papillary thyroid carcinoma (PTC) is the most common thyroid malignancy.
• N1a and N1b staging indicates lymph node metastasis in PTC.
• Understanding distant metastasis patterns is crucial for treatment planning.

Purpose of the Study:

• To characterize distant metastasis in N1a/N1b PTC patients.
• To evaluate the role of lateral lymph node metastasis as a risk factor for distant metastasis.

Main Methods:

• Retrospective analysis of 283 patients with N1a/N1b PTC.
• Data collected from Hyogo Medical University and Shikoku Cancer Center.
• Median follow-up of 73 months.

Main Results:

• Higher incidence of distant metastasis observed with involvement at levels II or V.
• Significant risk factors for distant metastasis included age ≥ 55, tumor size > 4 cm, and metastasis at levels II and V.
• p-values: 0.011 for age, 0.034 for tumor size, and 0.034 for lymph node levels II and V.

Conclusions:

• Lateral neck dissection is recommended for N1b PTC patients with metastasis at levels II or V.
• This approach should be considered alongside total thyroidectomy and postoperative radioactive iodine therapy.