Predictive factors for central compartment lymph node metastasis in thyroid papillary microcarcinoma.
OBJECTIVE
We examined the incidence of nodal involvement and attempted to determine the predictive factors for central compartment lymph node (LN) metastasis in thyroid papillary microcarcinoma (PMC).


METHODS
Retrospective chart review.


METHODS
We undertook a retrospective study of 52 patients treated between January 2000 and December 2005 for PMC by total thyroidectomy and elective central compartment LN dissection with or without comprehensive lateral neck dissection (n = 9). There were 45 women and 7 men whose mean age was 47.6 +/- 11.5 years. The following criteria were used to study the predictive value of central compartment LN metastasis: sex, age, multifocality of the tumor, extracapsular spread (ECS), the involvement of the lateral neck LN, tumor size, and tumor location.


RESULTS
In 16 of 52 (31%) patients, central compartment LN metastasis was found. With use of univariate and multivariate analysis, ECS, lateral LN metastasis, and tumor size (>5 mm) were independent correlates of central compartment metastasis. Sex, age, multifocality, and tumor location were not associated with central compartment LN metastasis and did not significantly influence the predictive value of these variables.


CONCLUSIONS
We found a significant association among ECS, lateral LN metastasis, tumor size (>5 mm), and central compartment LN metastasis in patients with PMC. A prophylactic neck dissection of the central compartment should be considered particularly in patients with ECS of the tumors, metastatic LN in the lateral neck, and a greater than 5 mm tumor size.
Lee
Sang-Hyuk
SH
Department of Otorhinolaryngology-Head and Neck Surgery, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, Seoul, Korea.
Lee
Seung-Suk
SS
Jin
Sung-Min
SM
Kim
Jin-Hwan
JH
Rho
Young-Soo
YS
D000328:Adult; D000368:Aged; D002291:Carcinoma, Papillary / Q000473:pathology / Q000556:secondary*; D004947:Esophagus / Q000473:pathology; D005260:Female; D005544:Forecasting; D006801:Humans; D008197:Lymph Node Excision; D008207:Lymphatic Metastasis / Q000473:pathology*; D008297:Male; D008875:Middle Aged; D037981:Neck Dissection; D009334:Neck Muscles / Q000473:pathology; D009361:Neoplasm Invasiveness; D009367:Neoplasm Staging; D012189:Retrospective Studies; D013964:Thyroid Neoplasms / Q000473:pathology*; D013965:Thyroidectomy