title: Correlation of minimal extrathyroidal extension with pathologic features of lymph node metastasis in patients with papillary thyroid carcinoma.
abstract: BACKGROUND
  The impact of minimal extrathyroidal extension (mETE) to the prognosis of patients with papillary thyroid carcinoma (PTC) is controversial. In this study, we investigated whether mETE is related to the aggressive biology of metastatic lymph node (LN) in patients with PTC.
  
  
  METHODS
  A retrospective review of 369 patients who had biopsy-confirmed cervical LN metastasis after initial surgery for PTC was conducted. The correlations of mETE with the specific features of metastatic LNs such as the LN size, number, LN ratio, and presence of extranodal extension (ENE) were statistically analyzed.
  
  
  RESULTS
  Size of the primary tumor (≥1 cm) had independent correlations to mETE (HR = 5.750). While mETE was related to number of metastatic LNs (≥5), LN ratio (≥0.31) and ENE in univariate analysis, only ENE (HR = 2.322) was independently correlated to mETE in our series. Along with mETE, size of primary tumor (≥1 cm) had significant impact on ENE (HR = 2.107).
  
  
  CONCLUSIONS
  Minimal ETE particularly those with larger primary tumor (≥1 cm) may be still considered as a significant factor regarding the management of cervical LNs in patients with PTC.
authors.affiliation: Department of Otolaryngology-Head and Neck Surgery, Kosin University College of Medicine, Busan, Korea.
authors.forename: Hyoung Shin
authors.initials: HS
authors.lastname: Lee
authors.affiliation: Department of Otolaryngology-Head and Neck Surgery, Kosin University College of Medicine, Busan, Korea.
authors.forename: Chanwoo
authors.initials: C
authors.lastname: Park
authors.affiliation: Department of Otolaryngology-Head and Neck Surgery, Kosin University College of Medicine, Busan, Korea.
authors.forename: Sung Won
authors.initials: SW
authors.lastname: Kim
authors.affiliation: Department of Otolaryngology-Head and Neck Surgery, Maryknoll Medical Center, Busan, Korea.
authors.forename: Taejung
authors.initials: T
authors.lastname: Park
authors.affiliation: Department of Pathology, Kosin University College of Medicine, Busan, Korea.
authors.forename: Bong Kwon
authors.initials: BK
authors.lastname: Chun
authors.affiliation: Department of Otolaryngology-Head and Neck Surgery, Dong-A University College of Medicine, Busan, Korea.
authors.forename: Jong Chul
authors.initials: JC
authors.lastname: Hong
authors.affiliation: Department of Otolaryngology-Head and Neck Surgery, Kosin University College of Medicine, Busan, Korea.
authors.forename: Kang Dae
authors.initials: KD
authors.lastname: Lee
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002291:Carcinoma, Papillary / Q000556:secondary* / Q000601:surgery; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008198:Lymph Nodes / Q000473:pathology* / Q000601:surgery; D008207:Lymphatic Metastasis; D008297:Male; D008875:Middle Aged; D009367:Neoplasm Staging; D011183:Postoperative Complications; D011379:Prognosis; D012189:Retrospective Studies; D012307:Risk Factors; D013961:Thyroid Gland / Q000473:pathology* / Q000601:surgery; D013964:Thyroid Neoplasms / Q000473:pathology* / Q000601:surgery; D013965:Thyroidectomy; D055815:Young Adult
keywords: extracapsular spread; lymph nodes; neck dissection; papillary thyroid carcinoma