Risk factors analysis of central neck lymph node metastases in clinically node-negative papillary thyroid carcinoma and the rationality of prophylactic central neck dissection

Abstract

Objective To explore the risk factors of central neck lymph node metastases in clinically node-negative (cN0) papillary thyroid carcinoma (PTC) and the rationality of prophylactic central neck dissection. Methods The clinical data of 1 359 patients who had underwent PTC treatment at the Department of Head and Neck Surgery, Henan Provincial Cancer Hospital during the five years (from 2011-01 to 2015-12) were analyzed retrospectively. Results There were 376 patients (27.67%, 376/1 359) with central neck lymph node metastases. Single factor analysis and multivariate Logistic regression analysis showed that the central neck lymph node metastases were related to tumor max diameter ≥ 10 mm, extrathyroidal extension (P<0.01), age <55 years old (P<0.01), multifocality (P<0.01), and PTC located at the isthmus (P<0.01). Conclusions Risk stratification should be performed on cN0 PTC. Prophylactic central neck dissection should be performed in cN0 patients with the tumor max diameter ≥ 10 mm, capsule invasion, age <55 years, multiple tumors, isthmus PTC and Hashimoto thyroiditis patients. Key words: Thyroid; Papillary thyroid carcinoma; Central lymph node; Lymph node metastasis; Lymph node dissection