Korean J Endocr Surg.  2016 Mar;16(1):6-12. 10.16956/kaes.2016.16.1.6.

Lateral Lymph Node Metastasis Prediction in Papillary Thyroid Cancer Patients with Suspicious Preoperative Imaging Findings

• Lee HS
• Jung EJ
• Kim JY
• Kwag SJ
• Park T
• Jeong SH
• Jeong CY
• Ju YT
• Lee YJ
• Hong SC
• Choi SK
• Ha WS

• KMID: 2158622
• DOI: http://doi.org/10.16956/kaes.2016.16.1.6

Abstract

PURPOSE
Lateral lymph node metastasis of papillary thyroid cancer (PTC) is indicative of tumor aggressiveness and can determine treatment strategies. However, the role of prophylactic lateral lymph node dissection in the management of PTC is unclear. This study evaluated factors predictive of lateral lymph node metastasis in patients with suspicious lymph node enlargement in preoperative imaging.
METHODS
This retrospective study included 728 patients with newly diagnosed PTC who underwent therapeutic surgery. Clinicopathologic results were reviewed, and factors predictive of lateral lymph node metastasis were analyzed.
RESULTS
Of the 242 patients with lymph node metastasis, 50 had lateral lymph node metastasis. Lateral lymph node metastasis was associated with sex, tumor size, preoperative thyroid stimulating hormone (TSH) concentration and presence of central lymph node metastasis. Among patients with suspicious lateral lymph node metastasis by ultrasonography, high TSH level (odds ratio 3.833, P=0.031) and number of metastatic central lymph nodes (odds ratio 3.68, P=0.025) were significantly predictive of lateral lymph node metastasis.
CONCLUSION
High serum TSH level and central lymph node metastasis were predictive of lateral lymph node metastasis in PTC patients with suspicious preoperative imaging findings. These predictive factors might help reduce unnecessary therapeutic lateral lymph node dissection.

Keyword

Papillary thyroid cancer; Lateral lymph node metastasis; TSH concentration; Ultrasonography

MeSH Terms

Humans
Lymph Node Excision
Lymph Nodes*
Neoplasm Metastasis*
Retrospective Studies
Thyroid Gland*
Thyroid Neoplasms*
Thyrotropin
Ultrasonography
Thyrotropin

Figure

• 

  Fig. 1. Numbers of metastatic lateral lymph nodes according to risk score. The table shows the components of the scoring system and the mean numbers of lateral lymph node metastasis is shown in the right panel.

Reference

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