title: Pathologic features of metastatic lymph nodes identified from prophylactic central neck dissection in patients with papillary thyroid carcinoma.
abstract: The importance of pathologic features of metastatic lymph nodes (LNs), such as size, number, and extranodal extension, has been recently emphasized in patients with papillary thyroid carcinoma (PTC). We evaluated the characteristics of metastatic LNs identified after prophylactic central neck dissection (CND) in patients with PTC. We performed a retrospective review of 1,046 patients who underwent unilateral or bilateral thyroidectomy with ipsilateral prophylactic CND. We reviewed the characteristics of the metastatic LNs and analyzed their correlation to the clinicopathologic characteristics of the primary tumor. Cervical LN metastasis after prophylactic CND was identified in 280 out of 1046 patients (26.8 %). The size of metastatic foci (≥2 mm) was independently correlated with primary tumor size (≥1 cm) (p = 0.016, OR = 1.88). Primary tumor size (≥1 cm) was also correlated to the number of metastatic LNs (≥5) (p = 0.004, OR = 3.14) and extranodal extension (p = 0.021, OR = 2.41) in univariate analysis. The size of the primary tumor affects pathologic features of subclinical LN metastasis in patients with PTC. Patients with primary tumors ≥1 cm have an increased risk of larger LN metastases (≥2 mm), an increased number of LN metastases (≥5), and a higher incidence of ENE, which should be considered in decision for prophylactic CND.
authors.affiliation: Department of Otolaryngology-Head and Neck Surgery, Kosin University College of Medicine, Busan, South 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, South 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, South Korea.
authors.forename: Sung Won
authors.initials: SW
authors.lastname: Kim
authors.affiliation: Department of Otolaryngology-Head and Neck Surgery, Kosin University College of Medicine, Busan, South Korea.
authors.forename: Woong Jae
authors.initials: WJ
authors.lastname: Noh
authors.affiliation: Kosin University College of Medicine, Busan, South Korea.
authors.forename: Soo Jin
authors.initials: SJ
authors.lastname: Lim
authors.affiliation: Department of Pathology, Kosin University College of Medicine, Busan, South Korea.
authors.forename: Bong Kwon
authors.initials: BK
authors.lastname: Chun
authors.affiliation: Department of Radiology, Kosin University College of Medicine, Busan, South Korea.
authors.forename: Beom Su
authors.initials: BS
authors.lastname: Kim
authors.affiliation: Department of Otolaryngology-Head and Neck Surgery, Dong-A University College of Medicine, Busan, South 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, South Korea. kdlee59@gmail.com.|Department of Otolaryngology Head and Neck Surgery, Kosin University Gospel Hospital, Am-Nam Dong 34, Seo-Gu, Busan, 602-702, South Korea. kdlee59@gmail.com.
authors.forename: Kang Dae
authors.initials: KD
authors.lastname: Lee
mesh_terms: D000328:Adult; D002277:Carcinoma / Q000473:pathology / Q000601:surgery; D002291:Carcinoma, Papillary; D005260:Female; D006801:Humans; D008198:Lymph Nodes / Q000473:pathology / Q000601:surgery; D008207:Lymphatic Metastasis; D008297:Male; D008875:Middle Aged; D037981:Neck Dissection / Q000379:methods*; D056910:Republic of Korea; D012189:Retrospective Studies; D012307:Risk Factors; D013223:Statistics as Topic; D000077273:Thyroid Cancer, Papillary; D013964:Thyroid Neoplasms / Q000473:pathology / Q000601:surgery; D013965:Thyroidectomy / Q000379:methods*; D047368:Tumor Burden
keywords: Lymph nodes; Lymphatic metastasis; Papillary thyroid carcinoma; Pathology