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KMID : 0371320080750030156
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Journal of the Korean Surgical Society
2008 Volume.75 No. 3 p.156 ~ p.161
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Analysis of the Relationship between Central Cervical Lymph Node Metastasis from Papillary Thyroid Carcinoma and the Associated Factors according to the Tumor Size
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Lee Kwan-Ju
Kim Hyung-Rae
Kim Say-June
Lee Sang-Chul
Kim Jeong-Gu
Sung Ki-Young
Park Woo-Chan
Oh Se-Jeong
Ahn Chang-Joon
Lee Dong-Ho
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Abstract
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Purpose: The aim of this study was to analyze the relationship between central lymph node metastasis and the associated factors in patients with papillary thyroid carcinoma (PTC) according to the tumor size, and we wanted to determine an appropriate treatment for PTC.
Methods: From June 2005 to May 2007, 218 patients with PTC underwent total thyroidectomy or lobectomy, and they also received central lymph node dissection at our institution. The patients were divided into three groups: group 1 (tumor ≤5 mm), group 2 (5 mm＜tumor≤10 mm), and group 3 (tumor＞10 mm). We retrospectively reviewed these patients to analyze the relationship between tumor size and the clinicopathological characteristics, including age, gender, lymph node metastasis, extrathyroidal extension, capsular invasion and lymphovascular invasion.
Results: There were 47 (21.6%) patients in group 1, 101 (46.3%) patients in group 2 and 70 (32.1%) patients in group 3. The tumor size was closely correlated with the presence of extrathyroidal extension, capsular invasion and lymph node metastasis (P＜0.001). Lymph node metastasis was not only closely correlated with tumor size, but it was also significantly associated with extrathyroidal extension, capsular invasion and lymphovascular invasion (P＜0.05).
Conclusion: Our study confirmed that some factors, including central lymph node metastasis, capsular invasion and extrathyroidal extension, were frequently observed in patients with papillary thyroid microcarcinoma (PTMC), and central lymph node metastasis was related to tumor size, extrathyroidal extension, capsular invasion and lymphovascular invasion. Therefore, routine central lymph node dissection is recommended during the initial surgery for patients with PTMC. (J Korean Surg Soc 2008;75:156-161)
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KEYWORD
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Papillary thyroid carcinoma, Papillary thyroid microcarcinoma, Central cervical lymph node, Tumor size
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