Open AccessPredictive factors for non-small-volume central lymph node metastases (more than 5 or ≥ 2 mm) in clinically node-negative papillary thyroid carcinoma
Author(s) -
Jian-Biao Wang,
Ya-Yu Sun,
Liuhong Shi,
Liping Xie
Publication year - 2019
Publication title -
medicine
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.59
H-Index - 148
eISSN - 1536-5964
pISSN - 0025-7974
DOI - 10.1097/md.0000000000014028
Subject(s) - medicine , lymph , neck dissection , lymph node , thyroid carcinoma , dissection (medical) , papillary thyroid cancer , incidence (geometry) , retrospective cohort study , radiology , oncology , carcinoma , thyroid , pathology , physics , optics
The benefits of prophylactic central neck dissection (pCND) for treating patients with clinical node-negative (cN0) papillary thyroid carcinoma (PTC) remain controversial. Lymph node metastases have been strongly associated with local recurrence and low survival, especially in PTC patients with 5 or more or ≥2 mm metastatic lymph nodes. The following study investigates the incidence and risk factors of more than 5 or ≥2 mm metastatic lymph nodes in the central compartment. A total of 611 patients with cN0 PTC were retrospectively analyzed. Cervical lymph nodes were harvested, and the size of metastatic lymph nodes was consequently analyzed. Non-small-volume central lymph node metastases (NSVCLNM), defined as more than 5 or ≥2 mm metastatic lymph nodes) were detected in 67 (11.0%) patients. Male gender, age ≤36 years, multifocal lesions, extrathyroidal extension, and tumor size > 0.85 cm were independent risk factors for NSVCLNM in cN0 PTC. The sensitivity and specificity of having ≥3 risk factors for predicting NSVCLNM was 46.3% and 86.8%, respectively. These findings suggest that pCND is a suitable treatment strategy for cN0 PTC patients with 3 or more risk factors for NSVCLNM.