title: Risk factors for central neck lymph node metastasis of clinically noninvasive, node-negative papillary thyroid microcarcinoma.
abstract: BACKGROUND
  To examine predictive factors for subclinical central neck lymph node metastases (LNM) of papillary thyroid microcarcinoma (PTMC).
  
  
  METHODS
  The clinical and pathological findings of 287 patients with clinically noninvasive, node-negative, solitary papillary thyroid carcinoma (PTC), who had undergone thyroidectomy plus central compartment neck dissection and showed pathologically confirmed nodal metastases, were analyzed. Predictive risk factors for central LNM were quantified.
  
  
  RESULTS
  Pathologic LNM was identified in 63 (32.6%) PTMC patients and 48 (51.0%) PTC patients (tumor size >1 cm; P = .003). Tumor size (>.7 cm; P = .011), multifocality (P = .010), and microscopic extracapsular extension (P = .050) were significant variables predictive of central LNM from PTMC in univariate analysis. Tumor size (odds ratio 2.28, 95% confidence interval 1.19 to 4.38; P = .014) and multifocality (odds ratio 2.38, 95% confidence interval 1.14 to 4.93; P = .020) were independent variables predictive of central LNM in multivariate analysis.
  
  
  CONCLUSIONS
  Cervical LNM is highly prevalent in clinically noninvasive, node-negative PTC. Central neck LNM is associated with larger tumor size and multifocality of PTMC.
authors.affiliation: Department of Otolaryngology, Asan Medical Center, University of Ulsan College of Medicine, 88 Olympic-ro 43-gil, Songpa-gu, Seoul 138-736, Republic of Korea.
authors.forename: Joon Pyo
authors.initials: JP
authors.lastname: Park
authors.affiliation: Department of Otolaryngology, Asan Medical Center, University of Ulsan College of Medicine, 88 Olympic-ro 43-gil, Songpa-gu, Seoul 138-736, Republic of Korea. Electronic address: rohjl@amc.seoul.kr.
authors.forename: Jong-Lyel
authors.initials: JL
authors.lastname: Roh
authors.affiliation: Department of Radiology, Asan Medical Center, University of Ulsan College of Medicine, 88 Olympic-ro 43-gil, Songpa-gu, Seoul 138-736, Republic of Korea.
authors.forename: Jeong Hyun
authors.initials: JH
authors.lastname: Lee
authors.affiliation: Department of Radiology, Asan Medical Center, University of Ulsan College of Medicine, 88 Olympic-ro 43-gil, Songpa-gu, Seoul 138-736, Republic of Korea.
authors.forename: Jung Hwan
authors.initials: JH
authors.lastname: Baek
authors.affiliation: Department of Pathology, Asan Medical Center, University of Ulsan College of Medicine, 88 Olympic-ro 43-gil, Songpa-gu, Seoul 138-736, Republic of Korea.
authors.forename: Gyungyub
authors.initials: G
authors.lastname: Gong
authors.affiliation: Department of Pathology, Asan Medical Center, University of Ulsan College of Medicine, 88 Olympic-ro 43-gil, Songpa-gu, Seoul 138-736, Republic of Korea.
authors.forename: Kyung-Ja
authors.initials: KJ
authors.lastname: Cho
authors.affiliation: Department of Otolaryngology, Asan Medical Center, University of Ulsan College of Medicine, 88 Olympic-ro 43-gil, Songpa-gu, Seoul 138-736, Republic of Korea.
authors.forename: Seung-Ho
authors.initials: SH
authors.lastname: Choi
authors.affiliation: Department of Otolaryngology, Asan Medical Center, University of Ulsan College of Medicine, 88 Olympic-ro 43-gil, Songpa-gu, Seoul 138-736, Republic of Korea.
authors.forename: Soon Yuhl
authors.initials: SY
authors.lastname: Nam
authors.affiliation: Department of Otolaryngology, Asan Medical Center, University of Ulsan College of Medicine, 88 Olympic-ro 43-gil, Songpa-gu, Seoul 138-736, Republic of Korea; Biomedical Research Institute, Korea Institute of Science and Technology, Seoul, Republic of Korea.
authors.forename: Sang Yoon
authors.initials: SY
authors.lastname: Kim
mesh_terms: D000328:Adult; D000368:Aged; D002277:Carcinoma / Q000000981:diagnostic imaging / Q000473:pathology / Q000601:surgery; D002291:Carcinoma, Papillary / Q000000981:diagnostic imaging / Q000473:pathology* / Q000601:surgery; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D016015:Logistic Models; D008207:Lymphatic Metastasis; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D037981:Neck Dissection; D009361:Neoplasm Invasiveness; D012307:Risk Factors; D000077273:Thyroid Cancer, Papillary; D013964:Thyroid Neoplasms / Q000000981:diagnostic imaging / Q000473:pathology* / Q000601:surgery; D013965:Thyroidectomy; D047368:Tumor Burden; D014463:Ultrasonography
keywords: Central neck; Lymph node dissection; Papillary thyroid carcinoma; Predictive factors; Subclinical lymph node metastasis