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Related Experiment Video

Updated: Jul 6, 2026

Transoral Robotic Total Thyroidectomy and Bilateral Central Regional Lymph Node Dissection for Papillary Thyroid Carcinoma
04:01

Transoral Robotic Total Thyroidectomy and Bilateral Central Regional Lymph Node Dissection for Papillary Thyroid Carcinoma

Published on: September 15, 2023

Rethinking indications for prophylactic central neck dissection in papillary thyroid microcarcinoma: A real-world

Lei Gong1, Ping Li2, Ziyang Zhang2

  • 1Department of Endocrinology and Metabolism, Qilu Hospital of Shandong University, Jinan, China; Shandong Provincial Key Laboratory of Spatiotemporal Regulation and Precision Intervention in Endocrine and Metabolic Diseases, Shandong Provincial Engineering Research Center for Advanced Technologies in Prevention and Treatment of Chromic Metabolic Diseases, Institute of Endocrine and Metabolic Diseases of Shandong University, Jinan, China.

American Journal of Otolaryngology
|July 4, 2026
PubMed
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For papillary thyroid microcarcinoma (PTMC), intraglandular tumors have the lowest risk of central lymph node metastasis (CLNM). Subcapsular or isthmic lesions indicate higher CLNM risk, warranting consideration for prophylactic central neck dissection (pCND) based on patient factors.

Area of Science:

  • Endocrinology
  • Surgical Oncology
  • Thyroid Cancer Research

Background:

  • The optimal management strategy for unifocal papillary thyroid microcarcinoma (PTMC) remains a subject of clinical debate.
  • Understanding risk factors for central lymph node metastasis (CLNM) is crucial for treatment decisions in PTMC.

Purpose of the Study:

  • To analyze preoperative clinical and postoperative pathological features of unifocal PTMC.
  • To provide evidence-based insights into the indications for prophylactic central neck dissection (pCND) in PTMC patients.

Main Methods:

  • Retrospective analysis of 1475 patients with clinical lymph node-negative (cN0) unifocal PTMC who underwent thyroid lobectomy and pCND.
  • Utilized univariate and multivariate logistic regression to identify independent risk factors for CLNM.
Keywords:
Central lymph node metastasisProphylactic central neck dissectionRisk factorsUnifocal papillary thyroid microcarcinoma

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Last Updated: Jul 6, 2026

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  • Employed a decision tree model to assess CLNM risk and guide pCND decisions.

    • Main Results:

    • Tumor location, age, gender, and size were identified as significant risk factors for CLNM in cN0 unifocal PTMC.
    • Intraglandular lesions demonstrated the lowest CLNM risk, irrespective of patient age, gender, or tumor size.
    • Subcapsular or isthmic lesions presented a higher CLNM risk, influenced by patient age, gender, and tumor size.

    Conclusions:

    • Patients with cN0 unifocal PTMC and intraglandular lesions have a minimal risk of CLNM.
    • Subcapsular or isthmic lesions necessitate careful consideration of pCND, integrating patient-specific factors like age, gender, and tumor size.
    • The decision for pCND in PTMC should be individualized based on tumor location and patient characteristics.