title: [Factors related to central lymph node metastasis in different subregions for unilateral papillary thyroid carcinoma with clinical N0 stage].
abstract: OBJECTIVE
  To study clinicopathologic factors related to central lymph node (CLN) metastasis in different subregions for unilateral papillary thyroid carcinoma (PTC) with clinical N0.
  
  
  METHODS
  A total of 145 PTC cases with clinical N0 treated in the same group of the department of head and neck surgery, Cancer Hospital, Chinese Academy of Medical Science between Jan. 2011 and Jan. 2014 was analysed retrospectively. Clinicopathologic factors related to CLN metastasis in different subregions were analyzed, including sex, age, tumor size, extrathyroidal extension, and multifocal tumor.
  
  
  RESULTS
  CLN metastases existed in 57.9% (84/145) cases and the incidences of ipsilateral paratracheal, pretracheal, and prelaryngeal metastasis were 53.8%, 24.1% and 11.3% respectively. Right paratracheal lymph node metastasis occurred in anterior (17/38, 44.7%) and posterior (12/38, 31.6%) to the recurrent laryngeal nerve. Multivariate analysis indicated that extrathyroidal extension (OR = 4.49, 95%CI 1.80-11.20, P = 0.001) and tumor size (OR = 2.17, 95%CI 1.06-4.45, P = 0.034) were independent risk factors for ipsilateral paratracheal CLN metastasis; ipsilateral paratracheal CLN metastasis (OR = 2.12, 95%CI 0.08-4.60, P = 0.003) was an independent risk factor for pretracheal CLN metastasis.
  
  
  CONCLUSIONS
  A high risk of CLN metastasis especially ipsilateral paratracheal metastasis exists in DTC with clinical N0. Ipsilateral paratracheal, pretracheal and prelaryngeal CLN dissection should be conducted when maximum tumor diameter more than 1 cm or extrathyroidal extension. CLN anterior and posterior to the recurrent larygeal nerve should be removed simultaneously when the ipsilateral paratracheal CLN metastasis at right side. Total thyroidectomy and contralateral paratracheal CLN dissection should be conciderded in multifocal tumor.
authors.affiliation: Department of Head and Neck Surgery, Cancer Hospital (Institute), Chinese Academy of Medical Sciences, Peking Union Medical College, Beijing 100021, China.
authors.forename: Yabing
authors.initials: Y
authors.lastname: Zhang
authors.affiliation: Department of Head and Neck Surgery, Cancer Hospital (Institute), Chinese Academy of Medical Sciences, Peking Union Medical College, Beijing 100021, China. Email: docbinzhang@hotmail.com.
authors.forename: Bin
authors.initials: B
authors.lastname: Zhang
authors.affiliation: Department of Head and Neck Surgery, Cancer Hospital (Institute), Chinese Academy of Medical Sciences, Peking Union Medical College, Beijing 100021, China.
authors.forename: Hanfeng
authors.initials: H
authors.lastname: Wan
authors.affiliation: Department of Head and Neck Surgery, Cancer Hospital (Institute), Chinese Academy of Medical Sciences, Peking Union Medical College, Beijing 100021, China.
authors.forename: Dangui
authors.initials: D
authors.lastname: Yan
authors.affiliation: Department of Head and Neck Surgery, Cancer Hospital (Institute), Chinese Academy of Medical Sciences, Peking Union Medical College, Beijing 100021, China.
authors.forename: Zhengang
authors.initials: Z
authors.lastname: Xu
authors.affiliation: Department of Head and Neck Surgery, Cancer Hospital (Institute), Chinese Academy of Medical Sciences, Peking Union Medical College, Beijing 100021, China.
authors.forename: Pingzhang
authors.initials: P
authors.lastname: Tang
mesh_terms: D002277:Carcinoma / Q000175:diagnosis*; D002291:Carcinoma, Papillary; D004210:Dissection; D015994:Incidence; D008197:Lymph Node Excision; D008198:Lymph Nodes; D008207:Lymphatic Metastasis / Q000175:diagnosis; D016403:Lymphoma, Large B-Cell, Diffuse; D015999:Multivariate Analysis; D009333:Neck; D016609:Neoplasms, Second Primary; D012009:Recurrent Laryngeal Nerve; D012189:Retrospective Studies; D012307:Risk Factors; D000077273:Thyroid Cancer, Papillary; D013964:Thyroid Neoplasms / Q000175:diagnosis*; D013965:Thyroidectomy