A Clinical Review of Lymph Node Metastases for Papillary Thyroid Cancer

ABSTRACT

BACKGROUND: Papillary thyroid cancer has a high frequency of lymph-node metastasis, but the methods for detecting and treating of lymph-node metastases remains controversial. We reviewed clinical analyses for lymph-node metastases. METHODS: Were retrospectively reviewed charts of 120 patients with papillary thyroid cancer who were treated from July 1994 to February 1997. Clinical aspects and the relationship between age, sex, tumor size, extracapsular invasion, multicentricity of the tumor and lymphadenopathy and the rate of lymph-node metastasis were investigated. RESULTS: Modified neck dissection was done in 97 patients, and lymph node metastases were detected in 72 patients (74.2%). Lymph-node meatastases were detected in 3 patients during routine central compartment neck dissection. The overall lymph-node metastasis was 62.5% (75 of 120). The mean number of metastastic nodes was 5.67, and the most frequent site was level VI. Lymph-node metastases were more frequent at a young age and for large sized tumors, extracapsular invasion and preoperatively palpable lymphadenopathy. CONCLUSIONS: The lymph-node metastatic rate is high for preoperatively palpable lymph node, tumor sizes over 4 cm, and extracapsular invasion (p<0.05). To reduce the recurrence rate, the surgeon shoud do a modified neck dissection on such above patients.