Clinically Related Factors and Features of Central Compartment Neck Lymph Nodes in Thyroid Micropapillary Carcinoma

Abstract

Background and Objectives:Despite the overall excellent prognosis for patients with thyroid papillary microcarcinoma (PMC), PMC is associated with central compartment lymph node metastasis. The aim of this study is to evaluate the effect of clinical and pathological factors affecting the central compartment lymph node metastasis in thyroid PMC. Subjects and Method:We undertook a retrospective study of 161 patients treated between January, 2003 and June, 2007 for papillary thyroid microcarci- noma by total thyroidectomy and central compartment neck dissection (n=161) with or without comprehensive lateral neck dissection. Following factors were included to analyze the relationship of tumor size and central compartment lymph node meta- stasis;sex, age, extracapsular extension, lymphovascular tumor emboli, multifocality, bilaterality, AMES risk group, lateral cervical lymph node involvement. Results:In 109 of 161 patients (67.7%), tumor size between 5-10 mm was significantly related with extracapsular extension (p=0.027) and also with the AMES high risk group (p=0.007). In 75 of 161 patients (46.6%), central compartment lymph node metastasis were found. By univariate analysis, tumor multifocality, bilaterality, and lateral lymph node involvement were related with central compartment lymph node metastasis. But on multivariate analysis, tumor bilaterality (p=0.008) and lateral lymph node involvement (p=0.018) were significantly related with central compart- ment lymph node metastasis. Conclusion:Prophylactic neck dissection of central compartment lymph nodes in PMC should be recommended as a routine procedure particularly for patients with tumor bilaterality and metastatic lymph nodes in the lateral neck. (Korean J Otorhinolaryngol-Head Neck Surg 2009;52:232-6)