Abstract
Objective To identify the risk factors for cervical lymph node metastasis (CLNM) and the feasibility of prophylactic central lymph node dissection. Methods The characteristics of 1107 patients were extracted and analyzed. Univariate and multivariate analyses were used to identify risk factors associated with lymph node metastasis. The relationship between the central lymph node dissection (CLND) and lateral lymph node metastasis (LLNM) was analyzed using the correlation analysis. Results The probability of CLNM was closely related to the male gender, age <55, and the increase of tumor size. Those patients with an increase in tumor size and CLNM were extremely prone to LLNM. Also, LLNM was more likely to happen in those with the more positive central lymph nodes. Routine prophylactic central lymph node dissection (P-CLND) did not increase the risk of complications. Conclusion P-CLND should be considered as a reasonable surgical treatment for PTC.
Highlights
Following the improvements of ultrasonography (US) and US-guided fine-needle aspiration biopsy (FNAB), the incidence of thyroid carcinoma has been increasing over recent decades
Patients were enrolled according to the following criteria: (1) all cases that were preoperatively suspected as Papillary thyroid carcinoma (PTC) following US examination, part of which were confirmed by FNAB—US characteristics include ultrasound intensity, composition, echoic distribution, tumor border, shape, calcification, aspect ratio, and blood flow; neck/thorax computer tomography (CT) is not systematically performed in our hospital—(2) all patients without clinical evidence of cervical lymph node metastasis (CLNM), who underwent unilateral or bilateral thyroidectomy with P-Central lymph node dissection (CLND) and with or without lateral lymph node dissection; (3) all patients who were proven to have PTC by intraoperative frozen and postoperative pathological examination; and (4) all patients who were without a history of previous thyroid or neck surgery
We focused on the association of lymph node metastasis (LNM) with the clinicopathological characteristics in this study. e male gender, age
Summary
Following the improvements of ultrasonography (US) and US-guided fine-needle aspiration biopsy (FNAB), the incidence of thyroid carcinoma has been increasing over recent decades. E favorable prognosis results in controversy regarding the optimal therapeutic strategy for PTC. The majority of patients with PTC have an excellent 10-year prognosis with a survival rate of more than 99% [1]. Some researchers, such as Ito, propose close follow-up for PTC patients instead of surgery [2]. Central lymph node dissection (CLND) is recommended for patients who are suspected of CLNM in preoperative assessment. Prophylactic central lymph node dissection (P-CLND) for patients with clinically node-negative is still controversial
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