Occult contralateral central lymph node metastases in papillary thyroid carcinoma with unilateral lymph node metastasis in the lateral neck.
BACKGROUND
The frequencies, pattern, and predictive factors for occult contralateral central lymph node (LN) metastases in papillary thyroid carcinoma (PTC) patients with unilateral lateral neck metastases are still unsettled.


METHODS
We reviewed the medical records of 70 consecutive PTC patients with unilateral positive lateral neck who have initially received total thyroidectomy and comprehensive neck dissection including bilateral central LN dissection. The relationships between occult LN metastases to the contralateral central neck compartment and preoperative image findings and clinicopathologic factors were analyzed.


RESULTS
Central neck LN metastases were present in 82.9%, in which 34.3% had bilateral central neck involvement and 48.6% had unilateral ipsilateral central neck involvement. Isolated contralateral central LN metastases without ipsilateral central LN metastases were not found. Multivariate analysis showed that the multifocality of primary thyroid tumor (p = 0.010, odds ratio = 5.120) and the presence of metastases in all lateral neck levels (p = 0.017, odds ratio = 5.130) were independent risk factors for the presence of contralateral central LN metastases.


CONCLUSIONS
The rate of occult contralateral central LN metastases was relatively high (34.3%) in PTC with ipsilaterally positive lateral neck, and multifocal primary tumor and positive LN involvement in all lateral neck levels are associated with contralateral central LN metastases.
Department of Otolaryngology-Head and Neck Surgery, Cancer Research Institute, Research Institute for Medical Sciences, Chungnam National University College of Medicine, Daejeon, Korea.
Bon Seok
BS
Koo
Eun Chang
EC
Choi
Yong-Ho
YH
Park
Eung-Hyub
EH
Kim
Young Chang
YC
Lim
D000328:Adult; D000368:Aged; D044963:Biopsy, Fine-Needle; D002291:Carcinoma, Papillary / Q000000981:diagnostic imaging / Q000473:pathology* / Q000601:surgery; D016009:Chi-Square Distribution; D005260:Female; D006801:Humans; D016015:Logistic Models; D008207:Lymphatic Metastasis / Q000000981:diagnostic imaging; D008297:Male; D008875:Middle Aged; D037981:Neck Dissection; D009361:Neoplasm Invasiveness; D011446:Prospective Studies; D011859:Radiography; D012189:Retrospective Studies; D012307:Risk Factors; D013964:Thyroid Neoplasms / Q000000981:diagnostic imaging / Q000473:pathology* / Q000601:surgery; D013965:Thyroidectomy; D014463:Ultrasonography