Risk factors for lymph node metastasis of cN0 papillary thyroid carcinoma

Abstract

Abstract Objective To investigate the risk factors for cervical lymph node metastasis of clinically lymph node-negative (cN0) papillary thyroid carcinoma (PTC). Methods Patients and Methods: The clinicopathologic data of patients with cN0 PTC who underwent at least one lobectomy plus central lymph node dissection at Xuzhou Central Hospital from January 2018 to December 2020 were retrospectively collected and the risk factors of lymph node metastasis analyzed. Univariate and multivariate analyses were performed to detect the risk factors for cervical lymph node metastasis. Results A total of 312 patients with cN0 PTC were enrolled in this study. The postoperative pathology results showed that 134 patients (42.9%) had central lymph node metastasis, of whom 24 (17.9%) had lateral lymph node metastasis (LLNM). The univariate analysis results showed that male gender, age <45 years, tumor diameter ≥10 mm, bilateral cancer, capsule invasion, and multiple foci were associated with cervical lymph node metastasis of cN0 PTC (P < 0.05). Further logistic regression analysis results showed that these factors, except age, were independent risk factors for cervical lymph node metastasis of cN0 PTC (P < 0.05). The results also showed that the risk of LLNM increased with an increase in the number of positive central lymph nodes in patients with cN0 PTC (P < 0.05). Conclusion Cervical lymph node metastasis of cN0 PTC is related to many factors, and a high number of positive central lymph nodes indicates a high risk of LLNM. Patients with risk factors should undergo preventive central lymph node dissection at the first surgery, and in patients with a high number of positive central lymph nodes, lateral lymph node dissection should be discreetly performed.