Highlights
- •Male, younger age, and tumor size are predictive of CLN metastasis in PTMCs.
- •ETE, multifocality, and intrathyroidal spreading are associated with CLN metastasis.
- •Coexisting chronic lymphocytic thyroiditis is associated with less CLN metastasis.
- •The presence of CLN metastasis is independently associated with LLN metastasis.
- •BRAF V600E mutation is not associated with cervical lymph node metastasis.
Abstract
Background
Optimal management for papillary thyroid microcarcinoma (PTMC) remains controversial.
The purpose of this study was to explore risk factors predictive of cervical lymph
node metastasis in conventional PTMCs.
Methods
Conventional PTMC patients (n = 2,404) undergoing surgery between 2010 and 2017 were
grouped and analyzed according to the positivity of cervical lymph node.
Results
Central lymph node (CLN) metastases and lateral lymph node (LLN) metastases were observed
in 915 (38.1%) and 184 (7.7%) cases, respectively. Multivariate analysis found that
male (odds ratio [OR] = 1.974, p < 0.001), younger age (OR = 1.601, p < 0.001), tumor size (OR = 1.935, p < 0.001), extrathyroidal extension (ETE) (OR = 1.647, p < 0.001), multifocality (OR = 1.416, p < 0.001), and intrathyroidal spreading (OR = 3.355, p < 0.001) predicted increased CLN metastasis. In particular, younger age, multifocality,
and intrathyroidal spreading were significantly associated with a high number of CLN
metastases (n ≥ 5). The presence of CLN metastasis was strongly associated with LLN
metastasis (OR = 5.426, p < 0.001).
Conclusion
Male, younger age, tumor size, ETE, multifocality, and intrathyroidal spreading predict
increased CLN metastasis in PTMCs. In patients with suspicious lateral lymphadenopathy,
the presence of CLN metastasis is independently associated with LLN metastasis.
Keywords
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Article info
Publication history
Published online: November 25, 2019
Accepted:
November 14,
2019
Received in revised form:
November 6,
2019
Received:
August 21,
2019
Identification
Copyright
© 2019 Elsevier Inc. All rights reserved.
