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Analysis of Risk Factors for High-Risk Lymph Node Metastasis in Papillary Thyroid Microcarcinoma
Yi-Hsiang Chiu1, Shu-Ting Wu1, Yung-Nien Chen1
1Division of Endocrinology and Metabolism, Department of Internal Medicine, Kaohsiung Chang Gung Memorial Hospital, Chang Gung University College of Medicine, 123 Ta-Pei Road, Niao-Sung District, Kaohsiung City 83301, Taiwan.
Cancers
|August 14, 2025
Summary
Male sex and extranodal extension predict high-risk lymph node metastasis in papillary thyroid microcarcinoma. This underscores the need for personalized risk assessment to guide treatment and improve outcomes for these patients.
Area of Science:
- Endocrinology
- Oncology
- Surgical Pathology
Background:
- Papillary thyroid microcarcinoma (PTMC) poses a risk of local recurrence, necessitating preoperative risk assessment.
- Identifying clinicopathological factors for high-risk lymph node metastasis (HRLNM) is crucial for patient outcomes.
- HRLNM is defined by ≥5 metastatic lymph nodes and/or lateral neck metastasis.
Purpose of the Study:
- To investigate clinicopathological factors associated with HRLNM in PTMC patients.
- To evaluate the impact of HRLNM on patient outcomes, including recurrence and survival.
Main Methods:
- Retrospective review of 985 PTMC patients who underwent thyroidectomy between 2013 and 2022.
- Analysis of clinicopathological data to identify predictors of HRLNM.
- Comparison of treatment response, recurrence rates, and survival between patients with and without lymph node metastasis.
Main Results:
- 10.2% of PTMC patients had lymph node metastasis (LNM); 27% of these had HRLNM.
- Male sex (OR 3.61) and extranodal extension (OR 3.76) were independent predictors of HRLNM.
- Patients with LNM had lower excellent treatment response rates, higher recurrence rates, and shorter recurrence-free survival.
Conclusions:
- Male sex and extranodal extension are significant risk factors for HRLNM in PTMC.
- Individualized risk stratification is essential for tailoring treatment strategies.
- Further research may clarify the long-term impact of HRLNM on patient survival.
