Abstract
Despite the majority of papillary thyroid microcarcinoma (PTMC) patients having an excellent prognosis, cervical lymph node metastases are common. The purpose of this study was to investigate the incidence and the predictive risk factors for occult central compartment lymph node metastasis (CLNM) in PTMC patients. 178 patients with clinically node-negative (cN0) PTMC undergoing prophylactic central compartment neck dissection in our hospital from January 2008 to Jun 2010 were enrolled. The relationship between CLNM and the clinical and pathological factors such as gender, age, tumor size, tumor number, tumor location, extracapsular spread (ECS), and coexistance of chronic lymphocytic thyroiditis was analyzed. Occult CLNM was observed in 41% (73/178) of PTMC patients. Multivariate analysis showed that male gender, tumor size (≥6mm) and ECS were independent variables predictive of CLNM in PTMC patients. Male gender, tumor size (≥6mm) and ECS were risk factors of CLNM. We recommend a prophylactic central lymph node dissection (CLND) should be considered in PTMC patients with such risk factors.
Highlights
Multivariate analysis showed that male gender, tumor size (≥6mm) and extracapsular spread (ECS) were independent variables predictive of compartment lymph node metastasis (CLNM) in papillary thyroid microcarcinoma (PTMC) patients
Papillary thyroid microcarcinoma (PTMC) is defined as a papillary thyroid carcinoma(PTC) with a lesion measuring 1 cm or less in maximal diameter according to the 2004 World Health Organization classification of thyroid tumors (DeLellis et al, 2004)
It has been accepted that patients with PTMC have a good prognosis
Summary
Papillary thyroid microcarcinoma (PTMC) is defined as a papillary thyroid carcinoma(PTC) with a lesion measuring 1 cm or less in maximal diameter according to the 2004 World Health Organization classification of thyroid tumors (DeLellis et al, 2004). Most surgeons agree with therapeutic cervical lymph node dissection in clinically node-positive PTC patients, prophylactic central neck lymphadectomy in the treatment of cN0 PTMC is controversial (Mazzaferri et al, 2009). Despite the majority of papillary thyroid microcarcinoma (PTMC) patients having an excellent prognosis, cervical lymph node metastases are common. The purpose of this study was to investigate the incidence and the predictive risk factors for occult central compartment lymph node metastasis (CLNM) in PTMC patients. Materials and Methods: 178 patients with clinically node-negative (cN0) PTMC undergoing prophylactic central compartment neck dissection in our hospital from January 2008 to Jun 2010 were enrolled. Multivariate analysis showed that male gender, tumor size (≥6mm) and ECS were independent variables predictive of CLNM in PTMC patients. We recommend a prophylactic central lymph node dissection (CLND) should be considered in PTMC patients with such risk factors
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