Abstract
BackgroundThe aim of this study is to evaluate whether the associations between clinicopathologic factors of papillary thyroid microcarcinoma (PTMC), especially tumor size, and subclinical central lymph node metastasis (LNM) are dependent on patient age.MethodsThe medical records of 428 patients who underwent thyroid surgery for PTC measuring ≤1 cm were reviewed. All patients were clinically lymph node negative and underwent thyroidectomy with unilateral or bilateral central lymph node dissection. Univariate and multivariate analyses were performed to identify clinicopathologic factors associated with central LNM.ResultsCentral LNM was identified in 96 of 428 (22.4%) patients. Mean tumor size was significantly greater in patients with than without central LNM (0.74 ± 0.22 cm vs. 0.64 ± 0.23 cm, P = 0.001). Tumor size > 0.5 cm was significantly predictive of central LNM. Subgroup analysis according to age groups showed that tumor size was an independent predictor of subclinical central LNM only in patients aged ≥45 years.ConclusionsFactors predictive of central LNM in patients with PTMC differed by age. PTMC size was an independent predictor of subclinical central LNM only in patients aged ≥45 years.
Highlights
The aim of this study is to evaluate whether the associations between clinicopathologic factors of papillary thyroid microcarcinoma (PTMC), especially tumor size, and subclinical central lymph node metastasis (LNM) are dependent on patient age
Most papillary thyroid microcarcinomas (PTMCs) have an indolent course and excellent prognosis, the longterm recurrence rate of PTMC has been reported to be as high as 12% [3-7], with lymph node metastasis (LNM) being one of the most important factors associated with local recurrence and distant metastasis [6,8,9]
Results from this study showed that the size of PTMCs was an independent predictor of subclinical central LNM only in patients ≥45 years old at the time of diagnosis
Summary
The aim of this study is to evaluate whether the associations between clinicopathologic factors of papillary thyroid microcarcinoma (PTMC), especially tumor size, and subclinical central lymph node metastasis (LNM) are dependent on patient age. The standard care for patients with thyroid cancer and involved lymph nodes is total thyroidectomy plus therapeutic cervical lymph node dissection. It has not yet been determined whether routine central lymph node dissection should be performed in patients with PTMC but without evident LNM. Preoperative ultrasonography is commonly recommended in staging of diseases of the thyroid and cervical lymph nodes, this method has limitations in diagnosing central LNM. Several studies have investigated the preoperative clinicopathologic feature of PTMC that are predictive of central LNM
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