title: Predictive factors for central lymph node metastasis in patients with cN0 papillary thyroid carcinoma: A systematic review and meta-analysis.
abstract: OBJECTIVE
  Recently, some single-institution studies have reported risk factors of CLNM in cN0 PTC patients, but results from those studies are not consistent. The meta-analysis aimed to identify some risk factors that can be predictive of CLNM in cN0 PTC patients.
  
  
  METHODS
  We performed a systematic search for relevant literature published prior to December 2015 using the following search engines: PubMed, EMBASE, Ovid and Web of Science. We included retrospective, prospective, and observational studies that investigated the risk factors for CLNM in patients with cN0 PTC.
  
  
  RESULTS
  Thirty-one studies, including 37,355 patients with cN0 PTC from seven countries were included in the meta-analysis. The pooled analysis indicated that age<45 years (OR = 1.57, 95%CI:1.48-1.66, P < 0.001), male gender (OR = 1.79, 95%CI: 1.69-1.91, P < 0.001), tumor size>10 mm (OR = 2.61, 95%CI:2.27-3.00, P < 0.001), bilaterality (OR = 1.52, 95%CI:1.31-1.77, P < 0.001), multifocality (OR = 1.46, 95%CI: 1.31-1.61, P < 0.001), extracapsular invasion (OR = 2.10, 95%CI:1.81-2.43, P < 0.001), angiolymphatic invasion (OR = 8.02, 95%CI:5.00-12.87, P < 0.001), high histologic risk (OR = 2.62, 95%CI:2.13-3.22, P < 0.001) and BRAF(V600E) mutation (OR:1.78, 95%CI:1.38-2.30, P < 0.001) were significantly associated with CLNM, and upper third location (OR = 0.54, 95%CI:0.43-0.67, P < 0.001) and lymphocytic thyroiditis (OR = 0.64, 95%CI:0.42-0.97, P = 0.034) were decreased risk factors of CLNM.
  
  
  CONCLUSIONS
  We identified several predictive factors for CLNM in cN0 PTC patients. Some certain risk factors could be considered in preoperative clinical decision regarding the necessity of prophylactic central lymph node dissection in cN0 PTC patients.
authors.affiliation: Department of Head and Neck Surgery, Fudan University, Shanghai Cancer Center, China; Department of Oncology, Shanghai Medical College, Fudan University, Shanghai 200032, China.
authors.forename: Ben
authors.initials: B
authors.lastname: Ma
authors.affiliation: Department of Head and Neck Surgery, Fudan University, Shanghai Cancer Center, China; Department of Oncology, Shanghai Medical College, Fudan University, Shanghai 200032, China. Electronic address: neck130@hotmail.com.
authors.forename: Yu
authors.initials: Y
authors.lastname: Wang
authors.affiliation: Department of Head and Neck Surgery, Fudan University, Shanghai Cancer Center, China; Department of Oncology, Shanghai Medical College, Fudan University, Shanghai 200032, China.
authors.forename: Shuwen
authors.initials: S
authors.lastname: Yang
authors.affiliation: Department of Head and Neck Surgery, Fudan University, Shanghai Cancer Center, China; Department of Oncology, Shanghai Medical College, Fudan University, Shanghai 200032, China.
authors.forename: Qinghai
authors.initials: Q
authors.lastname: Ji
mesh_terms: D000328:Adult; D002277:Carcinoma / Q000235:genetics / Q000473:pathology*; D002291:Carcinoma, Papillary; D005260:Female; D006801:Humans; D008207:Lymphatic Metastasis; D008297:Male; D008875:Middle Aged; D009154:Mutation; D009361:Neoplasm Invasiveness; D048493:Proto-Oncogene Proteins B-raf / Q000235:genetics; D012307:Risk Factors; D000077273:Thyroid Cancer, Papillary; D013964:Thyroid Neoplasms / Q000235:genetics / Q000473:pathology*
chemical_list: C482119:BRAF protein, human; D048493:Proto-Oncogene Proteins B-raf
keywords: BRAF(V600E); CLNM; Meta-analysis; PTC