Risk factors analysis of central neck lymph node metastases in clinically node-negative papillary thyroid carcinoma and the rationality of prophylactic central neck dissection / 中国医师进修杂志

ABSTRACT

Objective To explore the risk factors of central neck lymph node metastases in clinically node-negative (cN0) papillary thyroid carcinoma (PTC) and the rationality of prophylactic central neck dissection. Methods The clinical data of 1359 patients who had underwent PTC treatment at the Department of Head and Neck Surgery , Henan Provincial Cancer Hospital during the five years (from 2011-01 to 2015-12) were analyzed retrospectively. Results There were 376 patients (27.67％, 376/1359) with central neck lymph node metastases. Single factor analysis and multivariate Logistic regression analysis showed that the central neck lymph node metastases were related to tumor max diameter≥10 mm, extrathyroidal extension (P<0.01), age<55 years old (P<0.01), multifocality (P<0.01), and PTC located at the isthmus (P<0.01). Conclusions Risk stratification should be performed on cN0 PTC. Prophylactic central neck dissection should be performed in cN0 patients with the tumor max diameter ≥ 10 mm, capsule invasion, age <55 years, multiple tumors, isthmus PTC and Hashimoto thyroiditis patients.