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Risk factors for lateral neck lymph node metastasis in papillary thyroid ultra micro carcinoma with implications for active surveillance

  • 0Department of Surgery, Ajou University School of Medicine, Suwon, Republic of Korea.
Scientific Reports +

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August 20, 2025

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August 20, 2025

View abstract on PubMed

Summary

This summary is machine-generated.

Papillary thyroid ultra-microcarcinoma (PTUMC) under 0.5 cm can be monitored. However, microscopic extrathyroidal extension, upper pole location, psammomatous calcification, central node metastasis, and aggressive subtypes are key risk factors for lateral neck metastasis in PTUMC.

Area Of Science

  • Endocrinology
  • Oncology
  • Pathology

Background

  • Papillary thyroid ultra-microcarcinoma (PTUMC), defined as tumors ≤0.5 cm, presents a management dilemma due to potential for lateral neck node metastases.
  • Understanding PTUMC clinicopathological features is crucial for tailoring treatment strategies, balancing active surveillance with surgical intervention.

Purpose Of The Study

  • To evaluate the clinicopathological features of PTUMC.
  • To compare clinicopathological characteristics between PTUMC patients with and without lateral neck lymph node metastasis.

Main Methods

  • Retrospective analysis of 3,004 PTUMC patients treated between January 2009 and June 2013.
  • Comparison of clinicopathological variables (sex, age, size, location, multiplicity, thyroiditis, ETE, nodal status) between patients with and without lateral neck node metastasis.
  • Multivariate analysis to identify independent risk factors for lateral neck metastasis.

Main Results

  • Lateral neck node metastasis was observed in 3.0% (89/3,004) of PTUMC patients.
  • Patients with lateral neck metastasis showed significant differences in male sex, microscopic ETE, tumor multiplicity, upper pole location, psammomatous calcification, and central node metastasis.
  • Multivariate analysis identified microscopic ETE, upper pole lesions, psammomatous calcification, central neck node metastases, and aggressive subtype as independent risk factors for lateral neck metastasis.

Conclusions

  • Microscopic ETE, upper pole lesions, psammomatous calcification, central neck node metastases, and aggressive subtypes are significant independent risk factors for lateral neck metastasis in PTUMC.
  • These findings necessitate careful consideration when deciding between active surveillance and surgical intervention for PTUMC patients.
  • Risk stratification based on these factors can optimize management decisions for PTUMC.

Keywords: