title: Surgical extent of central lymph node dissection in clinically node-negative papillary thyroid cancer.
abstract: BACKGROUND
  The indications for elective bilateral central node dissection for patients with unilateral papillary thyroid carcinoma (PTC) who are clinically node negative are still not verified. We investigated the predictive factors of lymph node metastasis and formulated guidelines for surgical extent.
  
  
  METHODS
  From 2004 to 2009, 325 patients diagnosed with unilateral PTC who had undergone total thyroidectomy with bilateral central lymph node dissection (CLND) were enrolled retrospectively.
  
  
  RESULTS
  Central node metastasis was found in 45.2%, ipsilateral and contralateral lymph node metastasis was found in 40.0% and 16.0%, respectively. Tumor size larger than 1.0 cm and extrathyroidal extension were significant factors in predicting ipsilateral node metastasis (p = .004, < .001, respectively), and extrathyroidal extension and ipsilateral lymph node metastasis predicted contralateral node metastasis in multivariable analysis (p = .039, < .001, respectively).
  
  
  CONCLUSIONS
  Elective bilateral central node dissection may be considered in unilateral PTC with extrathyroidal extension or ipsilateral node metastasis.
authors: Department of Surgery, School of Medicine, Kyungpook National University, Daegu, Korea.
authors: Wan Wook
authors: WW
authors: Kim
authors: Ho Yong
authors: HY
authors: Park
authors: Jin Hyang
authors: JH
authors: Jung
mesh_terms: D000328:Adult; D000704:Analysis of Variance; D044963:Biopsy, Fine-Needle; D002277:Carcinoma / Q000401:mortality / Q000556:secondary* / Q000601:surgery*; D002291:Carcinoma, Papillary; D017115:Catheter Ablation / Q000379:methods; D015331:Cohort Studies; D017558:Elective Surgical Procedures / Q000379:methods; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007150:Immunohistochemistry; D008197:Lymph Node Excision / Q000379:methods; D008198:Lymph Nodes / Q000473:pathology / Q000601:surgery*; D008207:Lymphatic Metastasis; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D009361:Neoplasm Invasiveness / Q000473:pathology; D012189:Retrospective Studies; D018570:Risk Assessment; D015996:Survival Rate; D000077273:Thyroid Cancer, Papillary; D013964:Thyroid Neoplasms / Q000401:mortality / Q000473:pathology* / Q000556:secondary / Q000601:surgery*; D013965:Thyroidectomy / Q000379:methods* / Q000401:mortality; D016896:Treatment Outcome; D055815:Young Adult
keywords: cancer; extent; lymph node dissection; papillary; thyroid