Ipsilateral and contralateral central lymph node metastasis in papillary thyroid cancer: patterns and predictive factors of nodal metastasis

Head Neck. 2013 May;35(5):672-6. doi: 10.1002/hed.23016. Epub 2012 Jun 19.

Abstract

Background: The aims of this study were to evaluate the rate and risk factors of ipsilateral and contralateral central lymph node (CLN) metastases in patients with papillary thyroid cancer (PTC).

Methods: A total of 161 patients who underwent total thyroidectomy with prophylactic CLN dissection (CLND) to treat PTC were enrolled.

Results: Of 134 total cases excluding tumors located in the isthmus and bilateral lobes, 72 cases (53.7%) involved CLN metastases. Tumor size, age, and sex were found to be predictive of ipsilateral CLN metastasis and the rate of ipsilateral CLN metastasis in tumors > 1 cm was 59.6%. Contralateral CLN metastases were more prevalent only in tumors that already had ipsilateral CLN metastases (27.3%, p = .002).

Conclusions: It is suggested that risk factors of ipsilateral and contralateral CLN metastases should be considered while planning the extent of CLND in patients with clinically node-negative and unilateral PTC upon preoperative ultrasonography.

MeSH terms

  • Adult
  • Aged
  • Carcinoma / pathology*
  • Carcinoma, Papillary
  • Female
  • Humans
  • Lymph Node Excision
  • Lymphatic Metastasis
  • Male
  • Middle Aged
  • Multivariate Analysis
  • Neoplasm Metastasis
  • Risk Factors
  • Sensitivity and Specificity
  • Thyroid Cancer, Papillary
  • Thyroid Neoplasms / pathology*
  • Thyroidectomy
  • Young Adult