Analysis of correlation factors of contralateral central lymph node metastasis in unilateral papillary thyroid carcinoma with lateral cervical lymph node metastasis

Abstract

Objective: To examine the correlation factors of contralateral central lymph node metastasis in unilateral papillary thyroid carcinoma with lateral cervical lymph node metastasis. Methods: The clinical data of patients with unilateral papillary thyroid carcinoma who underwent total thyroidectomy and bilateral central lymph node dissection and ipsilateral cervical lymph node dissection from June 2016 to June 2018 at Department of Thyroid Surgery, West China Hospital, Sichuan University were analyzed retrospectively. A total of 317 patients, including 87 males and 230 females, aged (41.4±12.1) years (range: 16 to 75 years), were enrolled in this study. The risk factors of contralateral central lymph node metastasis were analyzed by χ2 test and Spearman correlation analysis. Results: There were 116, 69, 269, and 181 cases of pretracheal lymph node, prelaryngeal lymph node, ipsilateral central lymph node and contralateral central lymph node metastasis, respectively, and 16 cases of skipping metastasis. Univariate analysis showed that contralateral central lymph node metastasis was associated with gender, maximum tumor diameter, capsule invasion, pretracheal lymph node metastasis, prelaryngeal lymph node metastasis, and ipsilateral central lymph node metastasis (all P<0.05). Spearman correlation analysis showed that male (rs=0.162, P=0.004), maximum tumor diameter>10 mm (rs=0.184, P=0.001), capsule invasion (rs=0.135, P=0.016), pretracheal lymph node metastasis (rs=0.394, P<0.01), prelaryngeal lymph node metastasis (rs=0.272, P<0.01) and ipsilateral central lymph node metastasis (rs=0.203, P<0.01) were independent correlation factors for contralateral central lymph node metastasis. Conclusion: For patients with unilateral papillary thyroid carcinoma with ipsilateral cervical lymph node metastasis, bilateral central lymph node dissection should be considered if male, tumor diameter>10 mm, capsule invasion, pretracheal lymph node metastasis, prelaryngeal lymph node metastasis, or ipsilateral central lymph node metastasis.