Kosin Med J.  2022 Dec;37(4):311-319. 10.7180/kmj.22.136.

Risk factors for central and lateral lymph node metastasis in papillary thyroid carcinoma

• Ahn JH
• Chang HK

• KMID: 2538862
• DOI: http://doi.org/10.7180/kmj.22.136

Abstract

Background
Lymph node metastasis (LNM) is commonly observed in papillary thyroid carcinoma. This study aimed to investigate the risk factors for LNM in patients with papillary thyroid carcinoma.
Methods
The clinicopathological factors of 417 patients were investigated, and differences according to the presence or absence of LNM were evaluated.
Results
LNM was associated with age <55 years, male sex, tumor size >10 mm, multiple and bilateral tumors, tumor involving the lower pole or entire lobe, lymphovascular invasion (LVI), perineural invasion (PNI), and extrathyroidal extension (ETE). Univariable and multivariable analyses showed that age <55 years, male sex, tumor size >10 mm, LVI, and ETE were related to central LNM. Male sex, tumor size >10 mm, and LVI were correlated with lateral LNM (p<0.05). Compared to central LNM, more lymph nodes were involved in metastases and the metastatic tumors were larger in lateral LNM. Extranodal extension (ENE) was more commonly observed in lateral LNM (p<0.001) and was associated with tumor size >10 mm, multifocality, PNI, ETE, and the absence of lymphocytic thyroiditis (p<0.05).
Conclusions
Younger age, male sex, tumor size >10 mm, LVI, and ETE were risk factors for central LNM, while male sex, tumor size >10 mm, and LVI were risk factors for lateral LNM. ENE was more commonly observed in lateral LNM, and tumor size >10 mm, multifocal tumors, PNI, ETE, and tumors unrelated to lymphocytic thyroiditis were risk factors for ENE.

Keyword

Extranodal extension; Lymph node metastasis; Papillary thyroid cancer; Risk factors

Reference

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