Patterns and predictive factors of central lymph node metastasis in cN0 papillary thyroid carcinoma / 第二军医大学学报

ABSTRACT

Objective To evaluate the patterns and predictive factors of ipsilateral and contralateral central lymph node metastasis (CLNM) in the unilateral papillary thyroid carcinoma (PTC) patients with clinically node-negative neck (cN0). Methods We retrospectively reviewed the clinicopathological characteristics of 46 patients with cN0 unilateral PTC, including gender, age, multiplicity, tumor size, extrathyroidal extension, Hashimoto thyroiditis (HT), and T stage. Chi-square test and logistic regression were used to evaluate the patterns and predictive factors of ipsilateral and contralateral CLNM in cN0 unilateral PTC patients. Results Ipsilateral CLNM and contralateral CLNM were present in 32.6%(15/46) and 21.7% (10/46) of the patients, respectively. In patients with contralateral CLNM, 70.0% (7/10) had isolated contralateral CLNM without ipsilateral CLNM. Twenty patients of the 41 (48.8%) with T1/T2 stage had CLNM. Univariate analysis showed that tumor size >1 cm, age 1 cm (OR=4.890,P=0.044) was the independent predictor of ipsilateral CLNM, and HT (OR=0.086, P=0.034) was a protective factor of ipsilateral CLNM. Multifocal cancer was an independent predictor of contralateral CLNM (OR=7.60, P=0.038). Compared with isolated ipsilateral CLNM, contralateral CLNM occured more often in patients with HT (P1 cm, while contralateral PCND may be more valuable for patients with multifocal cancer or HT.