Central lymph node metastases in unilateral papillary thyroid microcarcinoma |
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| Authors: | Y. C. Lim E. C. Choi Y.‐H. Yoon E.‐H. Kim B. S. Koo |
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| Affiliation: | 1. Department of Otorhinolaryngology—Head and Neck Surgery, Konkuk University School of Medicine, Daejeon, Korea;2. Department of Otorhinolaryngology, Yonsei University College of Medicine, Seoul, Daejeon, Korea;3. Department of Otolaryngology—Head and Neck Surgery, Cancer Research Institute, Research Institute for Medical Sciences, Chungnam National University College of Medicine, Daejeon, Korea |
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| Abstract: | Background: The indications for and appropriate extent of prophylactic central lymph node (CLN) dissection for clinically node‐negative patients with unilateral papillary thyroid microcarcinoma (PTMC) are unknown. Methods: The frequency, patterns and predictive factors for CLN metastases in 86 patients with unilateral PTMC and a clinically node‐negative neck were analysed with respect to age and sex; metastasis, age, completeness, invasiveness, size (MACIS) score; tumour size; number and location of tumours; presence of ipsilateral CLN metastases; and presence of lymphovascular or capsular invasion. All patients underwent total thyroidectomy and CLN dissection. Results: Twenty‐seven (31 per cent) of 86 patients had metastatic CLNs: 18 ipsilateral and nine bilateral. Univariable analysis suggested male sex and tumour size greater than 0·5 cm to be significant factors in predicting ipsilateral CLN metastases. Only ipsilateral nodal positivity was a significant predictor of contralateral CLN metastases in multivariable analysis (P = 0·007). Conclusion: CLN metastases are relatively common in PTMC. Copyright © 2009 British Journal of Surgery Society Ltd. Published by John Wiley & Sons, Ltd. |
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