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Clinical Analysis of Risk Factors for Cervical Lymph Node Metastasis in Papillary Thyroid Microcarcinoma: A Retrospective Study of 3686 Patients

Authors Song J, Yan T, Qiu W, Fan Y, Yang Z

Received 17 February 2020

Accepted for publication 24 March 2020

Published 9 April 2020 Volume 2020:12 Pages 2523—2530

DOI https://doi.org/10.2147/CMAR.S250163

Checked for plagiarism Yes

Review by Single-blind

Peer reviewer comments 2

Editor who approved publication: Dr Yong Teng


Jianlu Song,* Ting Yan,* Wangwang Qiu, Youben Fan, Zhili Yang

Center of Thyroid and Parathyroid, Department of Thyroid, Parathyroid, Breast and Hernia Surgery, Shanghai Jiao Tong University Affiliated Sixth People’s Hospital, Shanghai 200233, People’s Republic of China

*These authors contributed equally to this work

Correspondence: Zhili Yang; Youben Fan
Center of Thyroid and Parathyroid, Department of Thyroid, Parathyroid, Breast and Hernia Surgery, Shanghai Jiao Tong University Affiliated Sixth People’s Hospital, Shanghai 200233, People’s Republic of China
Tel +86 21 24058412
Fax +86 21 24058933
Email yangzhililaoshi@126.com; fanyouben2006@163.com

Purpose: To investigate the risk factors for cervical lymph node metastasis (LNM) in papillary thyroid microcarcinoma (PTMC).
Patients and Methods: In total, 3686 patients with PTMC who underwent initial surgery in Shanghai Jiao Tong University affiliated Sixth People’s Hospital from January 2010 to December 2019 were retrospectively analyzed. Univariate and multivariate analyses were conducted to identify risk factors associated with cervical LNM.
Results: Male gender [odds ratio (OR) =1.420, P < 0.001], age < 55 years (OR =2.128, P < 0.001), tumor size > 6.5 mm (OR =2.112, P < 0.001), lymphovascular invasion (LVI) (OR =2.110, P =0.016), multifocality (OR =1.358, P =0.022), extrathyroidal extension (ETE) (OR =1.598, P < 0.001), and lateral LNM (LLNM) (OR =6.383, P < 0.001) served as independent risk factors for central LNM (CLNM). Moreover, male gender (OR =1.668, P =0.001), tumor size > 6.5 mm (OR =2.223, P < 0.001), chronic lymphocytic thyroiditis (OR =1.402, P =0.021), LVI (OR =4.582, P < 0.001), ETE (OR =1.393, P=0.023), and CLNM (OR =6.212, P < 0.001) served as independent risk factors for LLNM. Furthermore, solitary PTMC with lesions in the upper third of the thyroid gland were more associated with LLNM than lesions in the other regions.
Conclusion: This study suggests that meticulous evaluation of risk factors associated with LNM is required in order to guide the surgical treatment of PTMC patients in clinical practice.

Keywords: papillary thyroid microcarcinoma, predictors, central lymph node metastasis, lateral lymph node metastasis, extrathyroidal extension

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