Risk Factors of Central Lymph Node Metastasis in Papillary Thyroid Carcinoma of cN<sub>0</sub> Staging_CHINESE JOURNAL OF BASES AND CLINICS IN GENERAL SURGERY

Authors：

 LINXiao-dong ^1,2 , CHENXiao-yi ² , DUJia-lin ¹ , ZHAOGang ¹ , PENGLin ¹ , LIUQuan-fang ¹ , YAOYuan ¹ , HUANGYi-jie ¹ , YINYing ¹ , CHENZheng-bo ¹ , HUANGBao-jun ² ,  WUZe-yu ¹

1. The Second Department of General Surgery, Guangdong General Hospital, Guangdong Academy of Medical Sciences, Guangzhou 510080, Guangdong Province, China;
2. Shantou University Medical College, Shantou 515040, Guangdong Province, China;

Corresponding?author：

WUZe-yu, Email: Ljhde@163.com

Keywords：

Papillary thyroid carcinoma of cN₀ staging; Prophylactic central node dissection; Central lymph node metastasis; Risk factors

DOI：

10.7507/1007-9424.20150176

Video：

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Objective To evaluate the risk factors for central lymph node metastasis (CLNM) in papillary thyroid carcinoma (PTC) of cN₀ staging. Methods Clinical data of 94 patients with cN₀ PTC in Guangdong General Hospital who underwent thyroidectomy with prophylactic central node dissection (pCND) from March to July in 2014 were collected to analyze the risk factors of CLNM by using univariate and multivariate analysis methods. Results CLNM was found in 43 patients (45.7%). Multivariate analysis results showed that, the CLNM rate of patients with age < 45 years, tumor located in front of lobe by ultrasound, diameter of tumor > 2 cm, capsular invasion, and total number of central lymph node dissected > 3 were significantly higher (P < 0.05). Conclusion Age < 45 years, tumor located in front of lobe by ultrasound, and diameter of tumor > 2 cm are the risk factors of CLNM in patients with cN₀ PTC, pCND should be performed for patients with some of the above risk factors.

Citation： LINXiao-dong, CHENXiao-yi, DUJia-lin, ZHAOGang, PENGLin, LIUQuan-fang, YAOYuan, HUANGYi-jie, YINYing, CHENZheng-bo, HUANGBao-jun, WUZe-yu. Risk Factors of Central Lymph Node Metastasis in Papillary Thyroid Carcinoma of cN₀ Staging. CHINESE JOURNAL OF BASES AND CLINICS IN GENERAL SURGERY, 2015, 22(6): 683-687. doi: 10.7507/1007-9424.20150176 Copy

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2.	Ries LAG, Melbert D, Krapcho M, et al. SEER cancer statistics review, 1975-2005. Bethesda, MD:National Cancer Institute, 2008:1975-2005.
3.	Choi Y, Park KJ, Ryu S, et al. Papillary thyroid carcinoma involving cervical neck lymph nodes:correlations with lymphangiogenesis and ultrasound features. Endocr J, 2012, 59(10):941-948.
4.	Podnos YD, Smith D, Wagman LD, et al. The implication of lymph node metastasis on survival in patients with well-differentiated thyroid cancer. Am Surg, 2005, 71(9):731-734.
5.	Zaydfudim V, Feurer ID, Griffin MR, et al. The impact of lymph node involvement on survival in patients with papillary and follicular thyroid carcinoma. Surgery, 2008, 144(6):1070-1078.
6.	Barczyński M, Konturek A, Stopa M, et al. Nodal recurrence in the lateral neck after total thyroidectomy with prophylactic central neck dissection for papillary thyroid cancer. Langenbecks Arch Surg, 2014, 399(2):237-244.
7.	Goropoulos A, Karamoshos K, Christodoulou A, et al. Value of the cervical compartments in the surgical treatment of papillary thyroid carcinoma. World J Surg, 2004, 28(12):1275-1281.
8.	任立軍, 楊延芳, 張成雷.甲狀腺乳頭狀癌淋巴結轉移規律的臨床研究.中國普外基礎與臨床雜志, 2011, 18(4):419-422.
9.	Moo TA, Mcgill J, Allendorf J, et al. Impact of prophylactic central neck lymph node dissection on early recurrence in papillary thyroid carcinoma. World J Surg, 2010, 34(6):1187-1191.
10.	Eun YG, Lee YC, Kwon KH. Predictive factors of contralateral paratracheal lymph node metastasis in papillary thyroid cancer:prospective multicenter study. Otolaryngol Head Neck Surg, 2014, 150(2):210-215.
11.	Lee KE, Chung IY, Kang E, et al. Ipsilateral and contralateral central lymph node metastasis in papillary thyroid cancer:patterns and predictive factors of nodal metastasis. Head Neck, 2013, 35(5):672-676.
12.	Koo BS, Choi EC, Yoon YH, et al. Predictive factors for ipsilateral or contralateral central lymph node metastasis in unilateral papillary thyroid carcinoma. Ann Surg, 2009, 249(5):840-844.
13.	滕衛平, 劉永鋒, 高明, 等.甲狀腺結節和分化型甲狀腺癌診治指南.中國腫瘤臨床, 2012, 39(17):1249-1272.
14.	朱精強.分化型甲狀腺癌頸淋巴結清掃的相關問題.中國普外基礎與臨床雜志, 2012, 19(8):809-813.
15.	任國勝, 蘇新良.分化型甲狀腺癌頸淋巴結清掃術式的選擇.中國普外基礎與臨床雜志, 2010, 17(8):765-767.
16.	Rotstein L. The role of lymphadenectomy in the management of papillary carcinoma of the thyroid. J Surg Oncol, 2009, 99(4):186-188.
17.	Giordano D, Valcavi R, Thompson GB, et al. Complications of central neck dissection in patients with papillary thyroid carcinoma:results of a study on 1 087 patients and review of the literature. Thyroid, 2012, 22(9):911-917.
18.	Wang Q, Chu B, Zhu J, et al. Clinical analysis of prophylactic central neck dissection for papillary thyroid carcinoma. Clin Transl Oncol, 2014, 16(1):44-48.
19.	Wu Y, Gu J, Shang J, et al. Central lymph node metastasis in cN0 papillary thyroid carcinoma. J BUON, 2013, 18(3):733-738.
20.	Chae BJ, Jung CK, Lim DJ, et al. Performing contralateral central lymph node dissection in papillary thyroid carcinoma:a decision approach. Thyroid, 2011, 21(8):873-877.
21.	Ahn BH, Kim JR, Jeong HC, et al. Predictive factors of central lymph node metastasis in papillary thyroid carcinoma. Ann Surg Treat Res, 2015, 88(2):63-68.
22.	Miao S, Mao X, Pei R, et al.Predictive factors for different subgroups of central lymph node metastasis in unilateral papillary thyroid carcinoma.ORL J Otorhinolaryngol Relat Spec, 2013, 75(5):265-273.
23.	Park JP, Roh JL, Lee JH, et al.Risk factors for central neck lymph node metastasis of clinically noninvasive, node-negative papillary thyroid microcarcinoma.Am J Surg, 2014, 208(3):412-418.
24.	Liang K, He L, Dong W, et al.Risk factors of central lymph node metastasis in cN0 papillary thyroid carcinoma:a study of 529 patients.Med Sci Monit, 2014, 20:807-811.
25.	Hartl DM, Leboulleux S, Al Ghuzlan A, et al.Optimization of staging of the neck with prophylactic central and lateral neck dissection for papillary thyroid carcinoma.Ann Surg, 2012, 255(4):777-783.

1. ?Hundahl SA, Fleming ID, Fremgen AM, et al. A National cancer data base report on 53 856 cases of thyroid carcinoma treated in the U.S., 1985-1995. Cancer, 1998, 83(12):2638-2648.
2. Ries LAG, Melbert D, Krapcho M, et al. SEER cancer statistics review, 1975-2005. Bethesda, MD:National Cancer Institute, 2008:1975-2005.
3. Choi Y, Park KJ, Ryu S, et al. Papillary thyroid carcinoma involving cervical neck lymph nodes:correlations with lymphangiogenesis and ultrasound features. Endocr J, 2012, 59(10):941-948.
4. Podnos YD, Smith D, Wagman LD, et al. The implication of lymph node metastasis on survival in patients with well-differentiated thyroid cancer. Am Surg, 2005, 71(9):731-734.
5. Zaydfudim V, Feurer ID, Griffin MR, et al. The impact of lymph node involvement on survival in patients with papillary and follicular thyroid carcinoma. Surgery, 2008, 144(6):1070-1078.
6. Barczyński M, Konturek A, Stopa M, et al. Nodal recurrence in the lateral neck after total thyroidectomy with prophylactic central neck dissection for papillary thyroid cancer. Langenbecks Arch Surg, 2014, 399(2):237-244.
7. Goropoulos A, Karamoshos K, Christodoulou A, et al. Value of the cervical compartments in the surgical treatment of papillary thyroid carcinoma. World J Surg, 2004, 28(12):1275-1281.
8. 任立軍, 楊延芳, 張成雷.甲狀腺乳頭狀癌淋巴結轉移規律的臨床研究.中國普外基礎與臨床雜志, 2011, 18(4):419-422.
9. Moo TA, Mcgill J, Allendorf J, et al. Impact of prophylactic central neck lymph node dissection on early recurrence in papillary thyroid carcinoma. World J Surg, 2010, 34(6):1187-1191.
10. Eun YG, Lee YC, Kwon KH. Predictive factors of contralateral paratracheal lymph node metastasis in papillary thyroid cancer:prospective multicenter study. Otolaryngol Head Neck Surg, 2014, 150(2):210-215.
11. Lee KE, Chung IY, Kang E, et al. Ipsilateral and contralateral central lymph node metastasis in papillary thyroid cancer:patterns and predictive factors of nodal metastasis. Head Neck, 2013, 35(5):672-676.
12. Koo BS, Choi EC, Yoon YH, et al. Predictive factors for ipsilateral or contralateral central lymph node metastasis in unilateral papillary thyroid carcinoma. Ann Surg, 2009, 249(5):840-844.
13. 滕衛平, 劉永鋒, 高明, 等.甲狀腺結節和分化型甲狀腺癌診治指南.中國腫瘤臨床, 2012, 39(17):1249-1272.
14. 朱精強.分化型甲狀腺癌頸淋巴結清掃的相關問題.中國普外基礎與臨床雜志, 2012, 19(8):809-813.
15. 任國勝, 蘇新良.分化型甲狀腺癌頸淋巴結清掃術式的選擇.中國普外基礎與臨床雜志, 2010, 17(8):765-767.
16. Rotstein L. The role of lymphadenectomy in the management of papillary carcinoma of the thyroid. J Surg Oncol, 2009, 99(4):186-188.
17. Giordano D, Valcavi R, Thompson GB, et al. Complications of central neck dissection in patients with papillary thyroid carcinoma:results of a study on 1 087 patients and review of the literature. Thyroid, 2012, 22(9):911-917.
18. Wang Q, Chu B, Zhu J, et al. Clinical analysis of prophylactic central neck dissection for papillary thyroid carcinoma. Clin Transl Oncol, 2014, 16(1):44-48.
19. Wu Y, Gu J, Shang J, et al. Central lymph node metastasis in cN0 papillary thyroid carcinoma. J BUON, 2013, 18(3):733-738.
20. Chae BJ, Jung CK, Lim DJ, et al. Performing contralateral central lymph node dissection in papillary thyroid carcinoma:a decision approach. Thyroid, 2011, 21(8):873-877.
21. Ahn BH, Kim JR, Jeong HC, et al. Predictive factors of central lymph node metastasis in papillary thyroid carcinoma. Ann Surg Treat Res, 2015, 88(2):63-68.
22. Miao S, Mao X, Pei R, et al.Predictive factors for different subgroups of central lymph node metastasis in unilateral papillary thyroid carcinoma.ORL J Otorhinolaryngol Relat Spec, 2013, 75(5):265-273.
23. Park JP, Roh JL, Lee JH, et al.Risk factors for central neck lymph node metastasis of clinically noninvasive, node-negative papillary thyroid microcarcinoma.Am J Surg, 2014, 208(3):412-418.
24. Liang K, He L, Dong W, et al.Risk factors of central lymph node metastasis in cN0 papillary thyroid carcinoma:a study of 529 patients.Med Sci Monit, 2014, 20:807-811.
25. Hartl DM, Leboulleux S, Al Ghuzlan A, et al.Optimization of staging of the neck with prophylactic central and lateral neck dissection for papillary thyroid carcinoma.Ann Surg, 2012, 255(4):777-783.

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Risk Factors of Central Lymph Node Metastasis in Papillary Thyroid Carcinoma of cN₀ Staging

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Risk Factors of Central Lymph Node Metastasis in Papillary Thyroid Carcinoma of cN0 Staging

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Risk Factors of Central Lymph Node Metastasis in Papillary Thyroid Carcinoma of cN₀ Staging