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Transoral Robotic Total Thyroidectomy and Bilateral Central Regional Lymph Node Dissection for Papillary Thyroid Carcinoma
Published on: September 15, 2023
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Risk Factors for Central Lymph Metastasis in Node-Negative Papillary Thyroid Carcinoma
Nigerian Journal of Clinical Practice
|November 29, 2025
Summary
Papillary thyroid cancer (PTC) frequently metastasizes to central compartment lymph nodes (CLNs). This study identified age, gender, tumor size, and lymphovascular invasion as key predictors of CLNM in cN0 PTC patients undergoing prophylactic central compartment lymph node dissection (CLND).
Area of Science:
- Oncology
- Surgical Oncology
- Head and Neck Surgery
Background:
- Papillary thyroid cancer (PTC) commonly metastasizes to central compartment lymph nodes (CLNs).
- The utility of prophylactic central compartment lymph node dissection (CLND) in clinically lymph node-negative (cN0) PTC patients remains debated.
- Identifying predictive factors for CLNM is crucial for optimizing surgical strategies.
Purpose of the Study:
- To investigate risk factors associated with central compartment lymph node metastasis (CLNM) in cN0 PTC patients.
- To evaluate the predictive value of various clinical and pathological factors for CLNM.
- To inform decision-making regarding selective CLND in PTC management.
Main Methods:
- Retrospective analysis of 264 cN0 PTC patients who underwent total thyroidectomy (TT) and prophylactic CLND.
- Evaluation of potential risk factors including age, sex, tumor size, multifocality, lymphovascular invasion (LVI), and extracapsular extension (ECE).
- Logistic regression analysis to determine significant predictors of CLNM.
Main Results:
- Central compartment lymph node metastasis (CLNM) was detected in 38.6% of patients.
- Significant differences between metastatic and non-metastatic groups were observed for age, gender, tumor size, harvested lymph node count, multifocality, and LVI.
- Logistic regression identified age, gender, tumor size, and LVI as independent predictors of CLNM.
Conclusions:
- The incidence of CLNM in cN0 PTC is substantial.
- Age, gender, tumor size, and LVI are significant risk factors for CLNM.
- These identified risk factors can aid surgeons in selecting appropriate candidates for prophylactic CLND, potentially refining surgical decision-making.
