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Updated: Jan 6, 2026
Transoral Robotic Total Thyroidectomy and Bilateral Central Regional Lymph Node Dissection for Papillary Thyroid Carcinoma
Published on: September 15, 2023
Risk Factors for Central Lymph Metastasis in Node-Negative Papillary Thyroid Carcinoma
Background:
The primary place of metastasis happens to be the central compartment lymph nodes (CLNs) in papillary thyroid cancer (PTC). However, the role of prophylactic CLND in the treatment of clinically lymph node-negative (cN0) cases remains controversial.
Aim:
The aim of the study is to examine the risk factors predictive of central compartment lymph node metastasis (CLNM) in patients with PTC who underwent prophylactic CLND in cN0 patients.
Methods:
Two hundred and sixty-four patients who underwent total thyroidectomy (TT) + prophylactic CLND between January 2012 and December 2016 for cN0 PTC were included in this study. Age, sex, histopathological diagnosis, tumor size, the number of harvested CLNs, multifocality, tumor localization, tumor bilaterality, the presence of chronic thyroiditis (CT), lymphovascular invasion (LVI), and extracapsular extension (ECE) were evaluated as the risk factors affecting CLNM.
Results:
CLNM was found in 102/264 patients (38.6%). There was a statistically significant difference between the two groups in terms of age, gender, tumor size, the number of harvested CLNs, tumor multifocality, and the presence of LVI. Logistic regression analysis was performed to investigate the effects of these variables, which were found to have statistically significant difference between the groups, on the occurrence of CLNM. Age, gender, tumor size, and LVI were found to cause CLNM.
Conclusion:
CLNM rate is high in PTC. Because prophylactic CLND is still a controversial topic, it may be an option for surgeons planning to perform selective CLND, to pay attention to certain risk factors.
