The Analysis of Central Cervical Lymph Nodes in Papillary Thyroid Carcinoma with Preoperative No Lymph Node Metastasis

Korean Journal of Head & Neck Oncology 2010;26(2):183-186.
Published online November 30, 2010.

Yun Jung Kim;Tae Kwun Ha;Sung Mock Ryu;Sang Hyo Kim

림프절 전이가 발견되지 않은(cN0) 유두상 갑상선 암의 중앙 경부 림프절 분석

김윤정;하태권;유성목;김상효

Abstract

Purpose
：Papillary thyroid carcinoma (PTC) is known for malignant tumor which has a favorable prognosis and long-term survival. Although the prognosis for patients with PTC is generally good, PTC tends to have highly metastatic property. The purpose of this study was to analyze the central compartment lymph node in papillary thyroid cancer with no lymph node metastasis clinically and to assess the significance of prophylactic node dissection. Methods ：A retrospective review was carried out in 394 patients with PTC who underwent sur-gery for the period from January 2004 to December 2006. The positive rate of the lymph node metastasis was analyzed. The relations between the central compartment lymph nodes and the patients’ age, gender, tumor size, exrathyroidal extension(ETE), multifocality, and bilaterality were comparatively analyzed in PTC patients with preoperative no lymph node metastasis. Results ：The enrolled patients were 40 male and 354 female cases. The 118 cases of them were found to have cervical lymph node metastasis. The mean age was 46 years(range, 15-77years). Tumor size(p=0.000), ETE(p=0.001), multifocality(p=0.014), and bilaterality(p=0.001) were significantly related factors for cervical lymph node metastasis clinically in papillary thyroid cancer. However, age and gender were not significantly related with lymph node metastasis. Conclusion ：Although no lymph node metastasis clinically, prophylactic neck node dissection can be performed to avoid risks of local recurrence and reoperation in the light of PTC nature. The pathological status and high positive rate of central compartment lymph node relate to tumor size and extrathyroidal extension. Close surveillance for nodal status is required in follow-up.

Key Words: Papillary thyroid carcinoma, Central cervical lymph node, Lymph node dissection