Y C Lim1, E C Choi, Y-H Yoon, E-H Kim, B S Koo. 1. Department of Otorhinolaryngology - Head and Neck Surgery, Konkuk University School of Medicine, Seoul, Korea.
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.
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 CLNmetastases 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 CLNmetastases in multivariable analysis (P = 0.007). CONCLUSION:CLNmetastases are relatively common in PTMC.
Authors: Girish Mysore Suresh; Rajshekar Halkud; Ravi Arjunan; C Ramachandra; Syed Altaf; Durgesh Pandey; S Krishnamurthy Journal: Indian J Otolaryngol Head Neck Surg Date: 2019-02-19