title: Tumor size is the strongest predictor of microscopic lymph node metastasis and lymph node recurrence of N0 papillary thyroid carcinoma.
abstract: It is well-known that papillary thyroid carcinoma (PTC) frequently metastasizes to the regional (central and lateral) lymph nodes, even though it is diagnosed as node-negative on preoperative imaging studies.  In this study, we investigated predictors of microscopic node metastasis and lymph node recurrence of PTC without node metastasis detected preoperatively (N0).  Of the clinicopathological features that can be evaluated pre- and intraoperatively, tumor size (> 2 cm) was the strongest predictor of microscopic central and lateral node metastasis on multivariate logistic analysis.  Also, the tumor size most markedly affected lymph node recurrence, but not distant recurrence.  Lymph node recurrence may not be immediately life-threatening, but it can be a stressor both for physicians and patients.  Therefore, careful lymph node dissection is recommended for PTC with a large size, even though it is prophylactic.
authors.affiliation: Department of Surgery, Kuma Hospital, Kobe 650-0011, Japan. ito01@kuma-h.or.jp
authors.forename: Yasuhiro
authors.initials: Y
authors.lastname: Ito
authors.forename: Mitsuhiro
authors.initials: M
authors.lastname: Fukushima
authors.forename: Takuya
authors.initials: T
authors.lastname: Higashiyama
authors.forename: Minoru
authors.initials: M
authors.lastname: Kihara
authors.forename: Yuuki
authors.initials: Y
authors.lastname: Takamura
authors.forename: Kaoru
authors.initials: K
authors.lastname: Kobayashi
authors.forename: Akihiro
authors.initials: A
authors.lastname: Miya
authors.forename: Akira
authors.initials: A
authors.lastname: Miyauchi
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002291:Carcinoma, Papillary / Q000473:pathology* / Q000601:surgery; D002648:Child; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008197:Lymph Node Excision; D008198:Lymph Nodes / Q000473:pathology / Q000601:surgery; D008207:Lymphatic Metastasis / Q000473:pathology*; D008297:Male; D008875:Middle Aged; D009364:Neoplasm Recurrence, Local / Q000473:pathology* / Q000601:surgery; D011379:Prognosis; D013964:Thyroid Neoplasms / Q000473:pathology* / Q000601:surgery; D013965:Thyroidectomy