Journal of Otolaryngology and Ophthalmology of Shandong University ›› 2023, Vol. 37 ›› Issue (1): 64-71.doi: 10.6040/j.issn.1673-3770.0.2021.462

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A clinical study on prophylactic central lymph node dissection in early cN0 papillary thyroid carcinoma

XIAO Fuliang, LIN Yun, PAN Xinliang   

  1. Department of Otorhinolaryngology & Head and Neck Surgery, Qilu Hospital of Shandong University(Qingdao), Qingdao 266035, Shandong, China
  • Published:2023-02-06

Abstract: Objective In this study, we explore the risk factors and construct a predictive model for the occult central lymph node metastasis in early cN0 papillary thyroid carcinoma(PTC), combining with the complication rate of prophylactic central lymph node dissection(PCLND), to provide its decision basis. Methods Clinical data of 454 early cN0 PTC patients was retrospectively analyzed. And the incidence of complications was collected. Results Male, age ≤45, diameter>1 cm, and formation of microcalcifications were independent risk factors for occult central lymph node metastasis. A prediction model for occult lymph node metastasis in the central region was established: Logit(P)=-1.735-0.717×gender +0.442×age +1.245×tumor diameter +1.349×microcalcifications. And our PCLND did not increase the incidence of complications. Conclusion The model should be used to calculate the probability of occult central lymph node metastasis before surgery. The larger the P-value is, the higher the risk of lymph node metastasis will be, and PCLND should be performed for these patients. The incidence of temporary postoperative complications in our study is lower than other studies, which showing surgery with good skills will not increase the complication incidence after PCLND. Thus, for the possibility of occult central lymph node metastasis(33% in our study), PCLND should be actively performed in all patients with early cN0 PTC to remove possible occult malignant lymph nodes.

Key words: Papillary thyroid carcinoma, Central lymph node metastasis, Risk factors, Predictive model

CLC Number: 

  • R739.6
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