title: Tumor size and presence of calcifications on ultrasonography are pre-operative predictors of lymph node metastases in patients with papillary thyroid cancer.
abstract: OBJECTIVE
  Lymph node metastases in papillary thyroid cancer (PTC) are common and their presence can significantly alter the treatment for patients with PTC. We therefore sought to identify pre-operative predictors of lymph node metastases in patients with PTC.
  
  
  METHODS
  A thyroid tumor database was queried to identify patients with a pre-operative diagnosis of PTC and underwent thyroidectomy between January 2006 and August 2009. One hundred and three patients who had a pre-operative ultrasound and had lymph nodes surgically resected were identified. Clinical factors and tumor ultrasound characteristics were recorded. The pre-operative ultrasound results, type of operation, and final pathology results were also recorded.
  
  
  RESULTS
  Of the 103 patients, 74 (72%) were women and 29 (28%) were men with an age range of 15-78 years (median age of 43). Of the ultrasound characteristics evaluated only calcifications (P = 0.007) and size (P = 0.003) were statistically associated with positive cervical lymph nodes. None of the other demographic or clinical factors were significantly associated with lymph node metastases.
  
  
  CONCLUSIONS
  Thyroid nodule size and presence of calcifications on ultrasound were found to have a statistically significant association with lymph node metastases in patients with PTC. This information could be used to guide the surgical management of these patients.
authors: Endocrine Surgery Section, The Johns Hopkins University School of Medicine, Baltimore, Maryland 21287, USA. nrgomez01@gmail.com
authors: Nephtali R
authors: NR
authors: Gomez
authors: Guennadi
authors: G
authors: Kouniavsky
authors: Hua-Ling
authors: HL
authors: Tsai
authors: Helina
authors: H
authors: Somervell
authors: Sara I
authors: SI
authors: Pai
authors: Ralph P
authors: RP
authors: Tufano
authors: Christopher
authors: C
authors: Umbricht
authors: Jeanne
authors: J
authors: Kowalski
authors: Alan P B
authors: AP
authors: Dackiw
authors: Martha A
authors: MA
authors: Zeiger
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D002114:Calcinosis / Q000473:pathology*; D002291:Carcinoma, Papillary / Q000000981:diagnostic imaging* / Q000473:pathology* / Q000601:surgery; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008207:Lymphatic Metastasis; D008297:Male; D008875:Middle Aged; D011379:Prognosis; D015996:Survival Rate; D013964:Thyroid Neoplasms / Q000000981:diagnostic imaging* / Q000473:pathology* / Q000601:surgery; D013965:Thyroidectomy; D014463:Ultrasonography; D055815:Young Adult