Pattern of lymph node metastasis and the extent of lymph node dissection in papillary thyroid carcinoma

Abstract:

Objective：Papillary thyroid carcinoma is often complicated with lymph node metastases（LNM） and extent of lymph node dissection（LND） is under disscussion. The objectives of this retrospective study were to evaluate the pattern and predictive factors of cervical LNM and to determine the optimal lymph node management strategy. Methods：Between February 2010 and February 2013，96 patients who underwent surgical treatment for PTC at our hospital were retrospectively analyzed. All patients underwent LND at central and lateral sides. Neck dissection specimens were marked and separated according to neck levels and sent for pathology examination. Results：Overall，63 patients（65.6%） had nodal metastases to level Ⅵ，57（59.4%） to level Ⅲ，42（43.8%） to level Ⅱ，35（36.5%） to level Ⅳ，8（8.2%） to level Ⅴ. Gender（P=0.019） and extracapsular invasion（P=0.026） were significant predictive fac－tors of cervical LNM，and central LNM was significantly related with lateral LNM（P=0.014）. Conclusions：Ipsilateral central LND is recommended for all PTC patients. Whether to perform lateral LND and the extent of lateral LND are determined by results of central LND.