Characteristics of central compartment lymph node metastasis in patients with unilateral cN0 papillary thyroid carcinoma and prophylactic dissection

doi:10.16139/j.1007-9610.2021.02.013

Abstract

Abstract:

Objective To study the central compartment lymph node (CLN) metastasis in patients with unilateral pa-pillary thyroid carcinoma(PTC) diagnosed preoperatively and prophylactic dissection. Methods The data of 342 patients with unilateral PTC at cN₀ stage who underwent unilateral thyroidectomy, isthmusectomy and prophylactic CLN dissection were analyzed retrospectively in our department from January 2016 to December 2018. The characteristics of CLN metastasis were analyzed. Results Among 342 patients, 188(55.0%) patients had CLN metastasis. CLN metastasis was significantly related with age (P<0.001), sex (P<0.001), maximum diameter of tumor (P=0.001), capsular invasion (P=0.046), and more CLN (P<0.001). Metastatic CLN density is the metastatic CLN%, which was significantly related with sex (P=0.023) and capsular invasion (P=0.004). There was only one case with cervical hematoma and reoperation among all cases in this study. Two cases had temporary recurrent laryngeal nerve paralysis. Conclusions CLN metastasis in unilateral cN₀ PTC patients was characterized with relation to sex, age, and lymph node density. Therefore prophylactic CLN dissection is necessary and safe for unilateral cN₀ PTC patients.

Key words: Papillary thyroid carcinoma, Central compartment lymph node metastasis, Metastatic lymph node density, BRAF V600E

CLC Number:

R736.1

LIU Wei, WANG Cong, XUE Anwei, ZHAO Junjie, WANG Zhenglin. Characteristics of central compartment lymph node metastasis in patients with unilateral cN₀ papillary thyroid carcinoma and prophylactic dissection[J]. Journal of Surgery Concepts & Practice, 2021, 26(02): 159-162.

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References 15

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项目	总例数	CLNM组（n=188）	无CLNM组（n=154）	P值
性别
男	132(38.6)	89(47.3)	43(27.9)	<0.001
女	210(61.4)	99(52.7)	111(72.1)
年龄（岁）		40.7±12.1	45.7±11.3	<0.001
肿瘤最大径（cm）		1.1±0.6	0.9±0.6	0.001
≤0.5	76	29(38.2)	47(61.8)
0.6~1.0	153	77(50.3)	76(49.7)
>1.0	113	82(72.6)	31(27.4)
包膜侵犯（n）
有	178(52.0)	107(56.9)	71(46.1)	0.046
无	164(48.0)	81(43.1)	83(53.9)
腺体外侵犯（n）
有	32(9.4)	22(11.7)	10(6.5)	0.100
无	310(90.6)	166(88.3)	144(93.5)
多灶性（n）
有	54(15.8)	31(16.5)	23(14.9)	0.695
无	288(84.2)	157(83.5)	131(85.1)
CLN中位数（枚）		5	4	<0.001
术后并发症
颈部血肿		1	0	0.550
暂时性喉返神经损伤		1	1	0.700

项目	总例数^a)	BRAF V600E组（n=239）	无BRAF V600E组（n=94）	P值
性别				0.4
男	129(38.7%)	91	38
女	204(61.3%)	148	56
年龄（岁）		44.0±11.8	39.7±11.6	0.003
肿瘤最大径（cm）		1.03±0.66	0.98±0.56	0.5
包膜侵犯（n）				0.005
有	176(52.9%)	138	38
无	157(47.1%)	101	56
CLNM（n）				0.2
有	186(55.9%)	128	58
无	147(44.1%)	111	36
多灶性（n）				0.07
有	53(15.9%)	43	10
无	280(84.1%)	196	84

项目	总例数	CLNM密度(%)	P值
性别
男	89(47.3%)	66±30	0.023
女	99(52.7%)	55±32
年龄（岁）
>55	24（12.8%）	63±32	0.700
≤55	164（87.2%）	60±32
肿瘤最大径（cm）
>1	82（43.6%）	65±32	0.090
≤1	106（56.4%）	57±31
包膜侵犯（n）
有	107(57.0%)	66±32	0.004
无	81(43.0%)	53±30
腺体外侵犯（n）
有	22(11.7%)	69±32	0.170
无	166(88.3%)	59±31
多灶性（n）
有	31(16.5%)	61±32	0.500
无	157(83.5%)	57±32

Characteristics of central compartment lymph node metastasis in patients with unilateral cN₀ papillary thyroid carcinoma and prophylactic dissection

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