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Updated: Jun 17, 2026
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Transoral Robotic Total Thyroidectomy and Bilateral Central Regional Lymph Node Dissection for Papillary Thyroid Carcinoma
Published on: September 15, 2023
A nomogram for predicting high-volume central lymph node metastasis in unilateral clinically node-negative papillary
Ping Yu1, Zhan Chen1, Hongxiang Ji1
1Department of General Surgery, Chenggong Hospital (the 73rd Group Military Hospital of PLA), Xiamen University, Xiamen, China.
Gland Surgery
|June 16, 2026
Summary
A new nomogram helps predict high-volume central lymph node metastasis (CLNM) in papillary thyroid microcarcinoma (PTMC) patients. This tool aids in preoperative risk stratification for better surgical decisions.
Area of Science:
- Oncology
- Endocrine Surgery
- Diagnostic Tools
Background:
- Papillary thyroid microcarcinoma (PTMC) usually has an excellent prognosis.
- A subset of patients experiences high-volume central lymph node metastasis (CLNM), increasing recurrence risk.
- Preoperative risk stratification for high-volume CLNM in clinically node-negative (cN0) PTMC is challenging.
Purpose of the Study:
- Develop and validate a nomogram to predict high-volume CLNM in unilateral cN0 PTMC.
- Improve preoperative risk assessment for PTMC patients.
- Aid in surgical decision-making for PTMC management.
Main Methods:
- Retrospective study of 1,500 patients with unilateral cN0 PTMC.
- Random allocation to training (70%) and validation (30%) cohorts.
- Multivariate logistic regression to identify predictors of high-volume CLNM.
Main Results:
- Male sex, age ≤50, tumor diameter >8 mm, and multifocality predicted high-volume CLNM.
- The nomogram demonstrated good discrimination (C-index >0.70) in both cohorts.
- Calibration and decision curve analyses indicated favorable clinical applicability.
Conclusions:
- A practical nomogram for predicting high-volume CLNM in unilateral cN0 PTMC was developed.
- The nomogram facilitates individualized preoperative risk stratification.
- Assists clinicians in optimizing surgical strategies for PTMC.
