Abstract
Simple SummaryThe present study focused on patients affected by stage pT1a papillary thyroid micro-carcinomas that were treated with surgery and central lymph node dissection. In this study, male sex, low age, and sub-capsular carcinoma localization resulted as independent predictive factors for central lymph node metastases.Papillary thyroid micro-carcinomas are considered relatively indolent carcinomas, often occult and incidental, with good prognosis and favorable outcomes. Despite these findings, central lymph node metastases are common, and are related to a poor prognosis for the patient. We performed a retrospective analysis on patients treated with surgery for stage pT1a papillary thyroid micro-carcinomas. One hundred ninety-five patients were included in the analyses. The presence of central lymph node metastases was identified and studied. A multivariate analysis employing binary logistic regression was used to calculate adjusted odds ratios with 95% confidence intervals of possible central lymph node metastases risk factors. In the performed multivariate analysis, male gender, younger age, and histopathological characteristics, such as a tumor sub-capsular localization, were significantly associated with central lymph node metastases in pT1a patients. Central compartment lymph node metastases are present in a non-negligible number of cases in patients with papillary thyroid micro-carcinoma undergoing surgical resection. Studying these factors could be an effective tool for predicting patients’ central lymph node metastases in papillary thyroid micro-carcinomas, defining a tailored surgical treatment in the future.
Highlights
Papillary thyroid micro-carcinoma (PTMC) is defined by the World Health Organization as a papillary carcinoma (PTC) with a maximum size less than or equal to 1 cm [1]
The present study aims to evaluate the incidence of central lymph node metastases (CLNM) in a large series of patients affected by p-T1a PTMC, treated at a single institution over 23 years, and to identify possible risk factors associated with the presence of CLNM
(28.7%), sub-capsular localization was diagnosed in 66 patients (33.8%), and 52 PTMC
Summary
Papillary thyroid micro-carcinoma (PTMC) is defined by the World Health Organization as a papillary carcinoma (PTC) with a maximum size less than or equal to 1 cm [1]. The higher incidence could be partly due to increased diagnosis determined by improvements in imaging techniques and cytological examinations, while possible effects of lifestyles cannot be excluded, such as the salt iodization program [2,3,4]. Despite this increase, most PTMC patients have an indolent clinical course and a favorable prognosis. While the clinical significance of PTMC lymph node metastases remains a matter of discussion, recent studies have reported CLNM as a potential marker of aggressive behavior of PTMC and a risk factor for recurrence, distant metastases, reduced survival, and higher morbidity [20,21,22,23,24]
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