Predictive factors of central lymph node metastasis in papillary thyroid carcinoma
안병현, 김제룡, 정호철, 이진선, 장일성, 김용훈,
소속 상세정보
안병현 ( Ahn Byong-Hyon )
Chungnam National University College of Medicine Department of Surgery
김제룡 ( Kim Je-Ryong )
Chungnam National University College of Medicine Department of Surgery
정호철 ( Jeong Ho-Chul )
Chungnam National University College of Medicine Department of Surgery
이진선 ( Lee Jin-Sun )
Chungnam National University College of Medicine Department of Surgery
장일성 ( Chang Eil-Sung )
Chungnam National University College of Medicine Department of Surgery
김용훈 ( Kim Yong-Hun )
Konkuk University Chungju Hospital Department of Surgery
KMID : 0371420150880020063
Abstract
Purpose: The aim of this study was to evaluate the correlation between central lymph node (CLN) metastasis and clinicopathologic characteristics of papillary thyroid cancer (PTC). In addition, we investigated the incidence and risk factors for contralateral CLN metastasis in unilateral PTC. This study suggests the appropriate surgical extent for CLN dissection.
Methods: A prospective study of 500 patients with PTC who underwent total thyroidectomy and prophylactic bilateral CLN dissection was conducted.
Results: Of 500 patients, 255 had CLN metastases. The rate of CLN metastasis was considerably higher in cases of younger patients (<45 years old) (P < 0.001; odds ratio [OR], 2.357) and of a maximal tumor size greater than 1 cm (P < 0.001; OR, 3.165). Ipsilateral CLN metastasis was detected in 83.1% of cases (133/160) of unilateral PTC, only contralateral CLN metastases in 3.7% of cases (6/160), and bilateral CLN metastases in 13.1% of cases (21/160). The rate of contralateral CLN metastasis was considerably higher in cases of PTC with a large tumor size (≥1 cm) (P = 0.019; OR, 4.440) and with ipsilateral CLN metastasis (P = 0.047; OR, 2.613).
Conclusion: Younger age (<45 years old) and maximal tumor size greater than 1 cm were independent risk factors for CLN metastasis. Maximal tumor size greater than 1 cm and presence of ipsilateral CLN macrometastasis were independent risk factors for contralateral CLN metastasis. Therefore, both CLN dissections should be considered for unilateral PTC with a maximal tumor size greater than 1 cm or presence of ipsilateral CLN macrometastasis.
키워드
Lymph node; Metastasis; Papillary thyroid cancer
원문 및 링크아웃 정보
등재저널 정보