title: A Meta-analysis of Central Lymph Node Metastasis for Predicting Lateral Involvement in Papillary Thyroid Carcinoma.
abstract: OBJECTIVE
  Whether central lymph node metastasis is a reliable indicator of lateral lymph node metastasis in papillary thyroid carcinoma remains obscure. To investigate the value of central lymph node metastasis for predicting lateral compartment involvement, we performed a meta-analysis of published studies.
  
  
  METHODS
  A systematic literature search of PubMed, EMBASE, and Chinese National Knowledge Infrastructure databases was completed, and the reference lists of the identified articles and prior relevant reviews were examined.
  
  
  METHODS
  Two reviewers extracted data and assessed the quality of eligible studies independently. Odds ratios and 95% confidence intervals were pooled through a random effects meta-analysis model.
  
  
  RESULTS
  Twenty-one studies were eligible and further analyzed in this meta-analysis. The risk of lateral lymph node metastasis was significantly higher in the central lymph node-positive group than in the negative group (odds ratio = 7.64, 95% confidence interval: 5.59-10.44), with moderate heterogeneity across studies (P = .007, I(2) = 48.6%). Subgroup analyses and sensitivity analysis suggested that the results were consistent and credible. However, Begg's funnel plot and Egger linear regression test revealed a likelihood of publication bias (P = .000).
  
  
  CONCLUSIONS
  This meta-analysis suggests that central lymph node metastasis is valuable for predicting lateral compartment involvement in patients with papillary thyroid carcinoma. For those patients with central lymph node metastasis, additional attention should be paid to the lateral neck, as the risk of lateral lymph node metastasis was significantly higher in the central lymph node-positive group than in the negative group. Further studies regarding appropriate management for patients with high risk of lateral involvement are needed.
authors: Department of Thyroid Surgery, The First Affiliated Hospital of China Medical University, Shenyang, Liaoning Province, China.
authors: Xiabin
authors: X
authors: Lan
authors: Department of Thyroid Surgery, The First Affiliated Hospital of China Medical University, Shenyang, Liaoning Province, China.
authors: Wei
authors: W
authors: Sun
authors: Department of Thyroid Surgery, The First Affiliated Hospital of China Medical University, Shenyang, Liaoning Province, China haozhang@mail.cmu.edu.cn.
authors: Hao
authors: H
authors: Zhang
authors: Department of Thyroid Surgery, The First Affiliated Hospital of China Medical University, Shenyang, Liaoning Province, China.
authors: Wenwu
authors: W
authors: Dong
authors: Department of Thyroid Surgery, The First Affiliated Hospital of China Medical University, Shenyang, Liaoning Province, China.
authors: Zhihong
authors: Z
authors: Wang
authors: Department of Thyroid Surgery, The First Affiliated Hospital of China Medical University, Shenyang, Liaoning Province, China.
authors: Ting
authors: T
authors: Zhang
mesh_terms: D002277:Carcinoma / Q000175:diagnosis* / Q000556:secondary*; D002291:Carcinoma, Papillary; D006801:Humans; D008207:Lymphatic Metastasis; D011379:Prognosis; D000077273:Thyroid Cancer, Papillary; D013964:Thyroid Neoplasms / Q000175:diagnosis* / Q000556:secondary*
keywords: lymph nodes; lymphatic metastasis; meta-analysis; thyroid neoplasms