Risk factors for cervical lymph node metastasis in papillary thyroid microcarcinoma: a study of 1,587 patients

• Published in: Cancer biology & medicine Vol. 16; no. 1; pp. 121 - 130
• Main Authors: Zheng, Xiangqian, Peng, Chen, Gao, Ming, Zhi, Jingtai, Hou, Xiukun, Zhao, Jingzhu, Wei, Xi, Chi, Jiadong, Li, Dapeng, Qian, Biyun
• Format: Journal Article
• Language: English
• Published: China Department of Head and Neck Tumor, Tianjin Medical University Cancer Institute and Hospital, National Clinical Research Center for Cancer, Key Laboratory of Cancer Prevention and Therapy, Tianjin, Tianjin's Clinical Research Center for Cancer,Tianjin 300060, China%Department of Head and Neck, Shanxi Cancer Hospital, Taiyuan 030013, China%Department of Ultrasound, Tianjin Medical University Cancer Institute and Hospital, National Clinical Research Center for Cancer, Key Laboratory of Cancer Prevention and Therapy, Tianjin, Tianjin's Clinical Research Center for Cancer, Tianjin 300060, China%Department of Epidemiology, School of Public Health, Shanghai Jiao Tong University, Shanghai 200240, China 01.02.2019; Chinese Anti-Cancer Association; China Anti-Cancer Association
• Subjects: BRAFV600E mutation; CLNM; LLNM; Original; PTMC; risk factors; risk factors; BRAFV600E mutation; LLNM; CLNM; PTMC; BRAFv600E mutation
• ISSN: 2095-3941; 2095-3941
• DOI: 10.20892/j.issn.2095-3941.2018.0125

The purposes of this study were to identify risk factors for cervical lymph node metastasis and to examine the association between status and clinical features in papillary thyroid microcarcinoma (PTMC). A total of 1,587 patients with PTMC, treated in Tianjin Medical University Cancer Institute and Hospital from January 2011 to March 2013, underwent retrospective analysis. We reviewed and analyzed factors including clinical results, pathology records, ultrasound results, and status. Multivariate logistic regression analyses demonstrated that gender (male) [odds ratio (OR) = 1.845, = 0.000], age (< 45 years)(OR = 1.606, = 0.000), tumor size (> 6 mm) (OR = 2.137, = 0.000), bilateralism (OR = 2.011, = 0.000) and extrathyroidal extension (OR = 1.555, = 0.001) served as independent predictors of central lymph node metastasis (CLNM). Moreover, CLNM (OR = 29.354, = 0.000) served as an independent predictor of lateral lymph node metastasis (LLNM). Among patients with a solitary primary tumor, those with tumor location in the lower third of the thyroid lobe or the isthmus were more likely to experience CLNM ( < 0.05). Univariate analyses indicated that CLNM, LLNM, extrathyroidal extension, and multifocality were not significantly associated with mutation. The present study suggested that prophylactic neck dissection of the central compartment should be considered in patients with PTMC, particularly in men with tumor size greater than 6 mm, age less than 45 years, extrathyroidal extension, and tumor bilaterality. Among patients with PTMC, mutation is not significantly associated with prognostic factors. For a better understanding of surgical management of PTMC and the risk factors, we recommend multicenter research and long-term follow-up.