AI Article Synopsis
- The study aimed to analyze the link between central lymph node metastasis and clinical features of papillary thyroid cancer, while also assessing the risks of contralateral CLN metastasis in unilateral cases.
- A total of 500 patients with papillary thyroid cancer underwent total thyroid removal and CLN dissection, with findings showing a significant rate of metastasis linked to younger age and larger tumor size.
- Key risk factors for CLN metastasis were identified as being under 45 years old and having tumors larger than 1 cm; thus, surgical dissection of CLNs should be considered in specific unilateral cases based on these factors.
Article Abstract
Purpose: The aim of this study was to evaluate the correlation between central lymph node (CLN) metastasis and clinicopathologic characteristics of papillary thyroid cancer (PTC). In addition, we investigated the incidence and risk factors for contralateral CLN metastasis in unilateral PTC. This study suggests the appropriate surgical extent for CLN dissection.
Methods: A prospective study of 500 patients with PTC who underwent total thyroidectomy and prophylactic bilateral CLN dissection was conducted.
Results: Of 500 patients, 255 had CLN metastases. The rate of CLN metastasis was considerably higher in cases of younger patients (<45 years old) (P < 0.001; odds ratio [OR], 2.357) and of a maximal tumor size greater than 1 cm (P < 0.001; OR, 3.165). Ipsilateral CLN metastasis was detected in 83.1% of cases (133/160) of unilateral PTC, only contralateral CLN metastases in 3.7% of cases (6/160), and bilateral CLN metastases in 13.1% of cases (21/160). The rate of contralateral CLN metastasis was considerably higher in cases of PTC with a large tumor size (≥1 cm) (P = 0.019; OR, 4.440) and with ipsilateral CLN metastasis (P = 0.047; OR, 2.613).
Conclusion: Younger age (<45 years old) and maximal tumor size greater than 1 cm were independent risk factors for CLN metastasis. Maximal tumor size greater than 1 cm and presence of ipsilateral CLN macrometastasis were independent risk factors for contralateral CLN metastasis. Therefore, both CLN dissections should be considered for unilateral PTC with a maximal tumor size greater than 1 cm or presence of ipsilateral CLN macrometastasis.
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| http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4325652 | PMC |
| http://dx.doi.org/10.4174/astr.2015.88.2.63 | DOI Listing |
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