Korean J Otorhinolaryngol-Head Neck Surg.  2009 Mar;52(3):232-236. 10.3342/kjorl-hns.2009.52.3.232.

Clinically Related Factors and Features of Central Compartment Neck Lymph Nodes in Thyroid Micropapillary Carcinoma

• Kim YW
• Wang SG
• Lee JC
• Lee BJ
• Lee JW
• Kim YK
• Kim IJ
• Son SM

• KMID: 2277014
• DOI: http://doi.org/10.3342/kjorl-hns.2009.52.3.232

Abstract

BACKGROUND AND OBJECTIVES
Despite the overall excellent prognosis for patients with thyroid papillary microcarcinoma (PMC), PMC is associated with central compartment lymph node metastasis. The aim of this study is to evaluate the effect of clinical and pathological factors affecting the central compartment lymph node metastasis in thyroid PMC.
SUBJECTS AND METHOD
We undertook a retrospective study of 161 patients treated between January, 2003 and June, 2007 for papillary thyroid microcarcinoma by total thyroidectomy and central compartment neck dissection (n=161) with or without comprehensive lateral neck dissection. Following factors were included to analyze the relationship of tumor size and central compartment lymph node metastasis; sex, age, extracapsular extension, lymphovascular tumor emboli, multifocality, bilaterality, AMES risk group, lateral cervical lymph node involvement.
RESULTS
In 109 of 161 patients (67.7%), tumor size between 5-10 mm was significantly related with extracapsular extension (p=0.027) and also with the AMES high risk group (p=0.007). In 75 of 161 patients (46.6%), central compartment lymph node metastasis were found. By univariate analysis, tumor multifocality, bilaterality, and lateral lymph node involvement were related with central compartment lymph node metastasis. But on multivariate analysis, tumor bilaterality (p=0.008) and lateral lymph node involvement (p=0.018) were significantly related with central compartment lymph node metastasis.
CONCLUSION
Prophylactic neck dissection of central compartment lymph nodes in PMC should be recommended as a routine procedure particularly for patients with tumor bilaterality and metastatic lymph nodes in the lateral neck.

Keyword

Thyroid; Papillary microcarcinoma; Lymphatic metastasis; Neck dissection

MeSH Terms

Carcinoma, Papillary
Humans
Lymph Nodes
Lymphatic Metastasis
Multivariate Analysis
Neck
Neck Dissection
Neoplasm Metastasis
Prognosis
Retrospective Studies
Thyroid Gland
Thyroid Neoplasms
Thyroidectomy
Carcinoma, Papillary
Thyroid Neoplasms