Benefits of different surgical methods for 1-2 central lymph node metastases during operation of papillary thyroid carcinoma

Abstract:

Objective To explore the surgical method for papillary thyroid carcinoma（PTC） with 1-2 central lymph node metastases during surgery.Methods A total of 290 patients with PTC and 1-2 central lymph node metastases during the primary surgery in the Department of Breast and Thyroid Surgery of The First Affiliated Hospital of Chongqing Medical University were collected from January 2013 to December 2018，and their clinicopathological features were analyzed.Results The incidence of surgical complications in the hemithyroidectomy（HT） group was significantly lower than that in the total thyroidectomy group（P<0.001）. The surgical method did not affect the occurrence of structurally persistent/recurrent diseases（HR=2.848，95%CI=0.321-25.294，P=0.348）. The independent risk factors for total number of lymph node metastases >5 were tumor diameter >14.5 mm（OR=5.838，95%CI=2.295-14.850，P<0.001），tumor location in the upper part（OR=2.765，95%CI=1.154-6.624，P=0.023），and metastasis to zone Ⅲ lymph nodes（OR=17.310，95%CI=7.053-42.481，P<0.001）.Conclusion The current results support that the preferred surgical method for patients with PTC and 1-2 central lymph node metastases during surgery is HT. If the tumor is located in the upper part and has a diameter of more than 14.5 mm，it is recommended to undergo prophylactic ipsilateral neck lymph node dissection in zone Ⅲ.