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Central lymph node metastases in unilateral papillary thyroid microcarcinoma. BJS 2009; 96: 253-257.

Published: 17th February 2009

Authors: Y. C. Lim, E. C. Choi, Y.‐H. Yoon, E.‐H. Kim, B. S. Koo

Background

The indications for and appropriate extent of prophylactic central lymph node (CLN) dissection for clinically node‐negative patients with unilateral papillary thyroid microcarcinoma (PTMC) are unknown.

Method

The frequency, patterns and predictive factors for CLN metastases in 86 patients with unilateral PTMC and a clinically node‐negative neck were analysed with respect to age and sex; metastasis, age, completeness, invasiveness, size (MACIS) score; tumour size; number and location of tumours; presence of ipsilateral CLN metastases; and presence of lymphovascular or capsular invasion. All patients underwent total thyroidectomy and CLN dissection.

Results

Twenty‐seven (31 per cent) of 86 patients had metastatic CLNs: 18 ipsilateral and nine bilateral. Univariable analysis suggested male sex and tumour size greater than 0·5 cm to be significant factors in predicting ipsilateral CLN metastases. Only ipsilateral nodal positivity was a significant predictor of contralateral CLN metastases in multivariable analysis (P = 0·007).

Conclusion

CLN metastases are relatively common in PTMC. Copyright © 2009 British Journal of Surgery Society Ltd. Published by John Wiley & Sons, Ltd.

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