title: Risk factors for posterior to right recurrent laryngeal nerve lymph node metastasis in papillary thyroid carcinoma.
abstract: OBJECTIVE
  To identify the risk factors for posterior right recurrent laryngeal nerve lymph node metastasis (PRRLN-LNM) in papillary thyroid carcinoma (PTC).
  
  
  METHODS
  We conducted a retrospective study of 389 patients with primary PTC who underwent right lobectomy or total thyroidectomy, and comprehensive right or bilateral central compartment dissection (CCD) with or without lateral neck dissection (LND) between January 2010 and May 2013 at the Department of Head and Neck Surgery, Institute of Micro-Invasive Surgery of Zhejiang University, Zhejiang, China. The clinicopathological findings were investigated, and relative risk factors for PRRLN-LNM were analyzed.
  
  
  RESULTS
  Central compartment LNM were present in 50.9% (198/389), and PRRLN-LNM were present in 12.6% (49/389) of patients, wherein 3.1% (12/389) had PRRLN-LNM only. A multivariate analysis revealed that younger age (≤ 35 years), extrathyroidal extension (ETE), lateral compartment LNM, prelaryngeal LNM, pretracheal, and right paratracheal LNM were independent predictors of PRRLN-LNM.
  
  
  CONCLUSIONS
  This study revealed that younger age (≤ 35 years), ETE, prelaryngeal LNM, lateral compartment LNM, and pretracheal and right paratracheal lymph nodes (anterior to the right recurrent laryngeal nerve [level VIa]), LNM were independent factors of PRRLN-LN (level VIb). Therefore, comprehensive right CCD should be routinely performed for such patients.
authors.affiliation: Department of Head and Neck Surgery, Institute of Micro-Invasive Surgery of Zhejiang University, Sir Run Run Shaw Hospital, Medical School, Zhejiang University, Zhejiang, People's Republic of China. E-mail. zhangdeguang0330@163.com.
authors.forename: De-Guang
authors.initials: DG
authors.lastname: Zhang
authors.forename: Li
authors.initials: L
authors.lastname: Gao
authors.forename: Yu-Wen
authors.initials: YW
authors.lastname: Miao
authors.forename: Gao-Fei
authors.initials: GF
authors.lastname: He
authors.forename: Lei
authors.initials: L
authors.lastname: Xie
mesh_terms: D000328:Adult; D002277:Carcinoma / Q000473:pathology*; D002291:Carcinoma, Papillary; D005260:Female; D006801:Humans; D007823:Laryngeal Nerves / Q000473:pathology*; D008207:Lymphatic Metastasis; D008297:Male; D012008:Recurrence; D012189:Retrospective Studies; D012307:Risk Factors; D000077273:Thyroid Cancer, Papillary; D013964:Thyroid Neoplasms / Q000473:pathology*