Significance of the Extracapsular Spread of Metastatic Lymph Nodes in Papillary Thyroid Carcinoma.
OBJECTIVE
The extracapsular spread (ECS) of metastatic lymph nodes is associated with aggressive tumor behavior, and is regarded as a major risk factor for local recurrence in patients with head and neck squamous cell carcinoma. However, the significance of ECS of metastatic lymph nodes has not been well established in well-differentiated thyroid carcinoma. The purpose of this study was to examine this question.


METHODS
A retrospective review was performed of 335 patients with papillary thyroid carcinoma who underwent total thyroidectomy with lymph node dissection from April 2001 to December 2009. We analyzed various clinical characteristics, pathologic factors, and the size, number, and ECS of foci in metastatic lymph nodes.


RESULTS
On pathologic review, 201 of the patients (56.6%) had lymph node metastasis. This was significantly related to age and tumor size. ECS was noted in 64 of these 201 patients (31.8%), and was significantly related to male gender, tumor size, presence of extrathyroidal extension, metastatic lymph node size, and focus size. Recurrence occurred in 13 patients (3.9%), and the presence of ECS was significantly related to recurrence.


CONCLUSIONS
ECS of metastatic lymph nodes is an important prognostic factor for loco-regional recurrence in papillary thyroid carcinoma.
Department of Otolaryngology-Head and Neck Surgery, Hanyang University College of Medicine, Seoul, Korea.
Chang Ho
CH
Park
Department of Otolaryngology-Head and Neck Surgery, Hanyang University College of Medicine, Seoul, Korea.
Chang Myeon
CM
Song
Department of Otolaryngology-Head and Neck Surgery, Hanyang University College of Medicine, Seoul, Korea.
Yong Bae
YB
Ji
Department of Pathology, Hanyang University College of Medicine, Seoul, Korea.
Ju Yeon
JY
Pyo
Department of Pathology, Hanyang University College of Medicine, Seoul, Korea.
Ki Jong
KJ
Yi
Department of Pathology, Hanyang University College of Medicine, Seoul, Korea.
Young Soo
YS
Song
Department of Pathology, Hanyang University College of Medicine, Seoul, Korea.
Yong Wook
YW
Park
Department of Otolaryngology-Head and Neck Surgery, Hanyang University College of Medicine, Seoul, Korea.
Kyung
K
Tae
Extracapsular Spread; Metastatic Lymph Node; Thyroid Cancer, Papillary