Risk factors for cervical ipsilateral lymph node metastasis in papillary thyroid carcinoma

Abstract

Abstract Background: Papillary thyroid carcinoma (PTC)is the most common type of thyroid malignancy, characterized by slow progression, long survival, and low mortality rate. However, the cervical lymph node metastasis (CLNM) rate of PTC can reach up to 40%, and if the initial treatment is not appropriate, it is easy to relapse. Methods: We retrospectively analyzed the clinical data of 118 patients with PTC who underwent surgical treatment in our hospitals over the past decade. Furthermore, we analyzed whether the age, gender, tumor position, diameter, and other characteristics of patients were related to CLNM through univariate and multivariate analysis. At the same time, we also analyzed the factors related to skip metastasis in PTC. Results: The results of univariate analysis showed that CLMN was related to gender, tumor position, calcification, capsular infiltration, tumor diameter, tumor numbers, and lymph nodes of VI zone. Besides, the results of logistic regression analysis showed that CLMN was related to tumor position, calcification, tumor diameter, tumor numbers, and lymph nodes of VI zone. What’s more, we also found that upper polar thyroid tumors are more prone to jumping metastasis. Conclusion: The study of risk factors for CLNM in PTC will help identify patients who require selective lymph node dissection (SLND). Firstly, patients with primary tumor located in the upper pole of the thyroid gland need to carefully evaluate lymph node in the cervical region. Secondly, for PTC patients with negative preoperative evaluation of cervical lymph nodes, even if the VI area is judged negative during surgery, we still need to consider risk factors such as capsular infiltration, gender, and tumor position to comprehensively determine whether patients need SLND.