Central lymph node metastasis of cN0 papillary thyroid microcarcinoma: risk factors and operation methods

Abstract

Objective To study the relationship between clinicopathological features and central lymph nodes metastasis in patients with papillary thyroid microcarcinoma(PTMC). Methods From Jan. 2013 to Jun. 2013, 400 cases with PTMC in cN0 stage undergoing thyroidectomy and central neck dissection were collected. Results Univariate analysis showed that the rate of central lymph node metastasis in PTMC was 28.0%, nevertheless, the rate of central lymph node metastasis was 32.5%, 42.6%, 44.1%, 33.3%, and 37.4% respectively in patients aging below 45 years old, in male patients, in patients with extrathyroidal extension, in patients with tumor diameter larger than 5 mm and in patients with multifocality. Gender, age, extrathyroidal extension, tumor diameter, multifocality of patients had correlation with central lymph node metastasis. Multivariate binary logistic regression analysis revealed that the rate of lymph node metastasis significantly increased in cases of male, ageing below 45 years old, with extrathyroidal extension and multifocality(P<0.05). Conclusions The treatment for central lymph node metastasis of PTMC should be different considering elements including gender, age, multifocality of the tumor, and extrathyroidal extension. Prophylactic central lymphadenectomy should be performed when the primary lesion was resected. Key words: Papillary thyroid microcarcinoma; Central lymph node metastasis; Predictive factors