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KMID : 1141320220370040311
Kosin Medical Journal
2022 Volume.37 No. 4 p.311 ~ p.319
Risk factors for central and lateral lymph node metastasis in papillary thyroid carcinoma
Ahn Ji-Hyun

Chang Hee-Kyung
Abstract
Background Lymph node metastasis (LNM) is commonly observed in papillary thyroid carcinoma. This study aimed to investigate the risk factors for LNM in patients with papillary thyroid carcinoma.

Methods The clinicopathological factors of 417 patients were investigated, and differences according to the presence or absence of LNM were evaluated.

Results LNM was associated with age <55 years, male sex, tumor size >10 mm, multiple and bilateral tumors, tumor involving the lower pole or entire lobe, lymphovascular invasion (LVI), perineural invasion (PNI), and extrathyroidal extension (ETE). Univariable and multivariable analyses showed that age <55 years, male sex, tumor size >10 mm, LVI, and ETE were related to central LNM. Male sex, tumor size >10 mm, and LVI were correlated with lateral LNM (p<0.05).
Compared to central LNM, more lymph nodes were involved in metastases and the metastatic tumors were larger in lateral LNM. Extranodal extension (ENE) was more commonly observed in lateral LNM (p<0.001) and was associated with tumor size >10 mm, multifocality, PNI, ETE, and the absence of lymphocytic thyroiditis (p<0.05).

Conclusions Younger age, male sex, tumor size >10 mm, LVI, and ETE were risk factors for central LNM, while male sex, tumor size >10 mm, and LVI were risk factors for lateral LNM. ENE was more commonly observed in lateral LNM, and tumor size >10 mm, multifocal tumors, PNI, ETE, and tumors unrelated to lymphocytic thyroiditis were risk factors for ENE.
KEYWORD
Extranodal extension, Lymph node metastasis, Papillary thyroid cancer, Risk factors
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