title: Using foci number to predict central lymph node metastases of papillary thyroid microcarcinomas with multifocality.
abstract: OBJECTIVE
  The aim of our study is to analyze the clinicopathological characteristics and treatment options for papillary thyroid microcarcinomas with multifocality and investigated whether the number of foci in papillary thyroid microcarcinomas with multifocality can predict central lymph node metastases. Methods Records of 329 consecutive PTMC patients with multifocality, and who were treated surgically between 2003 and 2014 were reviewed. Patients with multifocality were identified by histopathology. The number of foci, size of the largest tumour, presence of extrathyroidal invasion, infiltration, and other clinicopathological parameters were collected and analyzed for all the cases.
  
  
  RESULTS
  Univariate analysis, age, sex, maximum tumour size, and extrathyroidal invasion were found to be significant prognostic factors (P = 0.001, 0.020, < 0.001, 0.043; respectively). Multivariate analysis found that age, sex, and maximum tumour size were independent prognostic factors for CLNM in PTMCs. Among them, Male patients (odds ratio 1.887; 95% confidence interval [CI] 1.053-3.380) and with maximum tumour size > 0.5 cm (odds ratio 2.819; 95% CI 1.721-4.616) were risk factors for increased incidence of CLNM. Patients ≥ 45 years (odds ratio 0. 497; 95% CI 0.309-0.800) were less likely to present with CLNM. However, extrathyroid invasion was not an independent predictor of CLNM according to our results. PTMCs with 2, 3, ≥ 4 foci had a significantly greater risk of CLNM (odds ratio 1.675, 2.360, 2.703; 95% CI 1.195-2.347, 1.425-3.906, 1.411-5.178; respectively) compared to PTMCs with unifocality.
  
  
  CONCLUSIONS
  Foci numbers were linked to an increased incidence of central lymph node metastases in papillary thyroid microcarcinomas with multifocality, and we could choose to perform more radical treatment in patients with multifocality.
authors: Department of Breast and Thyroid Surgery, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology Wuhan, China.
authors: Yawen
authors: Y
authors: Guo
authors: Department of Breast and Thyroid Surgery, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology Wuhan, China.
authors: Zeming
authors: Z
authors: Liu
authors: Department of Breast and Thyroid Surgery, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology Wuhan, China.
authors: Pan
authors: P
authors: Yu
authors: Department of Breast and Thyroid Surgery, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology Wuhan, China.
authors: Chunping
authors: C
authors: Liu
authors: Department of Breast and Thyroid Surgery, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology Wuhan, China.
authors: Jie
authors: J
authors: Ming
authors: Department of Breast and Thyroid Surgery, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology Wuhan, China.
authors: Ning
authors: N
authors: Zhang
authors: Department of Breast and Thyroid Surgery, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology Wuhan, China.
authors: Maimaiti
authors: M
authors: Yusufu
authors: Department of Breast and Thyroid Surgery, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology Wuhan, China.
authors: Chen
authors: C
authors: Chen
authors: Department of Breast and Thyroid Surgery, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology Wuhan, China.
authors: Tao
authors: T
authors: Huang
keywords: Papillary thyroid carcinoma; lymph node; metastases; number of foci