Risk Factors for Nodal Metastasis in cN0 Papillary Thyroid Microcarcinoma.
BACKGROUND
Despite the majority of papillary thyroid microcarcinoma (PTMC) patients having an excellent prognosis, cervical lymph node metastases are common. The purpose of this study was to investigate the incidence and the predictive risk factors for occult central compartment lymph node metastasis (CLNM) in PTMC patients.


METHODS
178 patients with clinically node-negative (cN0) PTMC undergoing prophylactic central compartment neck dissection in our hospital from January 2008 to Jun 2010 were enrolled. The relationship between CLNM and the clinical and pathological factors such as gender, age, tumor size, tumor number, tumor location, extracapsular spread (ECS), and coexistance of chronic lymphocytic thyroiditis was analyzed.


RESULTS
Occult CLNM was observed in 41% (73/178) of PTMC patients. Multivariate analysis showed that male gender, tumor size (≥6mm) and ECS were independent variables predictive of CLNM in PTMC patients.


CONCLUSIONS
Male gender, tumor size (≥6mm) and ECS were risk factors of CLNM. We recommend a prophylactic central lymph node dissection (CLND) should be considered in PTMC patients with such risk factors.
General Surgery Department, Peking Union Medical College Hospital, Chinese Academy of Medical Science, Beijing, China E-mail : Liyangzhang25@hotmail.com.
Li-Yang
LY
Zhang
Zi-Wen
ZW
Liu
Yue-Wu
YW
Liu
Wei-Sheng
WS
Gao
Chao-Ji
CJ
Zheng
D000328:Adult; D000367:Age Factors; D002291:Carcinoma, Papillary / Q000150:complications / Q000473:pathology* / Q000601:surgery; D016022:Case-Control Studies; D015331:Cohort Studies; D005260:Female; D050031:Hashimoto Disease / Q000150:complications / Q000473:pathology*; D006801:Humans; D016015:Logistic Models; D008198:Lymph Nodes / Q000473:pathology* / Q000601:surgery; D008207:Lymphatic Metastasis; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D009333:Neck; D037981:Neck Dissection; D009367:Neoplasm Staging; D009378:Neoplasms, Multiple Primary / Q000473:pathology* / Q000601:surgery; D012189:Retrospective Studies; D012307:Risk Factors; D012737:Sex Factors; D013964:Thyroid Neoplasms / Q000150:complications / Q000473:pathology* / Q000601:surgery; D013965:Thyroidectomy; D047368:Tumor Burden