Central lymph node metastases in unilateral papillary thyroid microcarcinoma.
BACKGROUND
The indications for and appropriate extent of prophylactic central lymph node (CLN) dissection for clinically node-negative patients with unilateral papillary thyroid microcarcinoma (PTMC) are unknown.


METHODS
The frequency, patterns and predictive factors for CLN metastases in 86 patients with unilateral PTMC and a clinically node-negative neck were analysed with respect to age and sex; metastasis, age, completeness, invasiveness, size (MACIS) score; tumour size; number and location of tumours; presence of ipsilateral CLN metastases; and presence of lymphovascular or capsular invasion. All patients underwent total thyroidectomy and CLN dissection.


RESULTS
Twenty-seven (31 per cent) of 86 patients had metastatic CLNs: 18 ipsilateral and nine bilateral. Univariable analysis suggested male sex and tumour size greater than 0.5 cm to be significant factors in predicting ipsilateral CLN metastases. Only ipsilateral nodal positivity was a significant predictor of contralateral CLN metastases in multivariable analysis (P = 0.007).


CONCLUSIONS
CLN metastases are relatively common in PTMC.
Lim
Y C
YC
Department of Otorhinolaryngology - Head and Neck Surgery, Konkuk University School of Medicine, Seoul, Korea.
Choi
E C
EC
Yoon
Y-H
YH
Kim
E-H
EH
Koo
B S
BS
D000328:Adult; D000368:Aged; D002291:Carcinoma, Papillary / Q000601:surgery*; D005260:Female; D006801:Humans; D008197:Lymph Node Excision / Q000379:methods*; D008207:Lymphatic Metastasis; D008297:Male; D008875:Middle Aged; D037981:Neck Dissection / Q000379:methods*; D011183:Postoperative Complications / Q000209:etiology*; D012189:Retrospective Studies; D013964:Thyroid Neoplasms / Q000601:surgery*; D013965:Thyroidectomy / Q000379:methods*