Analysis of risk factors for cervical lymph node metastasis of papillary thyroid microcarcinoma: a study of 268 patients

Abstract

Background: To investigate the risk factors of cervical lymph node (LN) metastasis in papillary thyroid microcarcinoma (PTMC) patients. Methods: We retrospectively analyzed the clinicopathologic data of all patients who received standard lobectomy for PTMC at our institution between October 2017 and January 2019. Central LNs were dissected in all patients. Lateral LNs were dissected if metastasis to the lateral LNs was suggested based on pre-op fine-needle aspiration biopsy. The relationship between variables available prior to surgery and cervical LN metastasis was examined using multivariate regression. Results: Post-op pathologic examination revealed cervical LN metastasis in 79 (29.5%) patients. Seventy subjects had metastasis only to central LNs, and 4 (1.5%) patients had metastasis only to lateral LNs. Five patients had metastasis to both central and lateral LNs. In comparison to patients without cervical LN metastasis, those with LN metastasis were significantly younger (40.63 ± 13.07 vs. 44.52 ± 12.23 years; P = 0.021) and had significantly larger tumor diameter on pathology (6.7 ± 2.2 vs. 5.9 ± 2.4 mm; P = 0.010). Multivariate regression analysis identified the following independent risks for cervical LN metastasis: male sex (OR 2.362, 95%CI 1.261~4.425; P = 0.007), age (OR 0.977, 95%CI 0.956~0.999; P = 0.042) and ultrasound tumor diameter at > 5 mm (OR 3.172, 95%CI 1.389~7.240; P = 0.006). Conclusion: Cervical LN metastasis occurs in a non-insignificant proportion of PTMC patients. Independent risks included male sex, younger age and larger tumor diameter on ultrasound.

Predictive Factors of Lymph Node Metastasis in Patients With Papillary Microcarcinoma of the Thyroid: Retrospective Analysis on 293 Cases

“…According to other studies present in the literature ( 12 , 13 , 18 – 23 ), we found younger age, tumor size, tall cell variant of PTC, extrathyroidal extension, and angioinvasion as independent risk factors for lymph node metastases.…”

Molecular characterisation and clinical correlation of papillary thyroid microcarcinoma

“…BRAF V600E mutation has been extensively studied to date and, although its role is valuable for prognosis when associated with other clinical features, its role as single prognostic marker remains uncertain [4,[12][13][14][15][16][17][18][19]. In our population, the most common mutation was the BRAF V600E and its prevalence was higher in non-incidental mPTCs than in those incidentally found, as already reported by other authors [20,21].…”

Atypical histiocytoid cells in fine‐needle aspiration cytology of metastatic papillary thyroid carcinoma: A potential diagnostic pitfall

“…PTC is one of the most common cancers in the world. Cervical lymph node metastasis might occur in the early stage with metastatic rates ranging from 20% to 50% in the existing literature 9,10 . The metastasis can be detected not only at the time of diagnosis of primary PTC, but also prior to or after the primary diagnosis.…”