title: Evaluation of thyroid isthmusectomy as a potential treatment for papillary thyroid carcinoma limited to the isthmus: A clinical study of 73 patients.
abstract: There are no specific therapeutic guidelines for thyroid cancers confined to the isthmus. To determine whether isthmic papillary thyroid carcinoma (PTC) can be treated with thyroid isthmusectomy and limited neck dissection, we analyzed factors related to central lymph node (CLN) metastasis in patients with clinically node-negative (cN0), solitary, isthmic PTC.
  
  
  
  We retrospectively reviewed 73 consecutive patients who underwent surgery for solitary isthmic, PTC. The frequency, pattern, and risk factors of CLN metastasis were analyzed.
  
  
  
  Occult CLN metastasis and paratracheal lymph node (PTLN) metastasis were detected in 34 patients (46.6%) and 28 patients (38.4%), respectively. On multivariate logistic regression analysis, male sex and tumor size >0.7 cm were associated with CLN metastasis, and age ≤38 years, tumor size >0.6 cm, and pretracheal lymph node positivity were associated with PTLN metastasis.
  
  
  
  Thyroid isthmusectomy for solitary isthmic PTC may be insufficient in patients with tumors >0.6 cm, those aged ≤38 years, and male patients. © 2015 Wiley Periodicals, Inc. Head Neck 38: E1510-E1514, 2016.
authors.affiliation: Department of Head and Neck Surgery, Institute of Micro-Invasive Surgery of Zhejiang University, Sir Run Run Shaw Hospital, Zhejiang University School of Medicine, Hangzhou, Zhejiang, China.
authors.forename: Jianbiao
authors.initials: J
authors.lastname: Wang
authors.affiliation: Sir Run Run Shaw Hospital, Zhejiang University School of Medicine, Hangzhou, Zhejiang, China.
authors.forename: Haili
authors.initials: H
authors.lastname: Sun
authors.affiliation: Department of Head and Neck Surgery, Institute of Micro-Invasive Surgery of Zhejiang University, Sir Run Run Shaw Hospital, Zhejiang University School of Medicine, Hangzhou, Zhejiang, China.
authors.forename: Li
authors.initials: L
authors.lastname: Gao
authors.affiliation: Department of Head and Neck Surgery, Institute of Micro-Invasive Surgery of Zhejiang University, Sir Run Run Shaw Hospital, Zhejiang University School of Medicine, Hangzhou, Zhejiang, China.
authors.forename: Lei
authors.initials: L
authors.lastname: Xie
authors.affiliation: Department of General Surgery, Institute of Micro-Invasive Surgery of Zhejiang University, Sir Run Run Shaw Hospital, Zhejiang University School of Medicine, Hangzhou, Zhejiang, China.
authors.forename: Xiujun
authors.initials: X
authors.lastname: Cai
mesh_terms: D000328:Adult; D002291:Carcinoma, Papillary / Q000601:surgery*; D005260:Female; D006801:Humans; D016015:Logistic Models; D008197:Lymph Node Excision; D008207:Lymphatic Metastasis; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D037981:Neck Dissection; D000077273:Thyroid Cancer, Papillary; D013964:Thyroid Neoplasms / Q000601:surgery*; D013965:Thyroidectomy
keywords: central lymph node metastasis; papillary thyroid carcinoma; risk factor; thyroid isthmus; thyroid isthmusectomy