Pattern and risk factors of central compartment lymph node metastasis in papillary thyroid cancer: A prospective study from an endocrine surgery centre

Abstract

Lymphatic metastasis in papillary thyroid cancer (PTC) is eminent; however, the extent of central compartment lymph nodes dissection (CCD) is controversial and requires the knowledge of pattern and risk factors for central compartment lymph nodes metastasis (CCM). We did a prospective study of 47 cases with PTC who underwent total thyroidectomy (TT) with CCD with/without lateral lymph nodes dissection (LND). Clinicopathological profile including CCM as ipsilateral and contralateral was documented. On histopathology, the mean tumour size was 3.57 ± 2.42 cm 59.6 had CCM, which was bilateral in the majority (60.72). The tumour-size was the most important predictor for lymph nodes metastasis-(P = 0.018) whereas multicentricity-(P = 0.002) and ipsilateral CCM-(P = 0.001) were the predictors for contralateral CCM. The long-term morbidity of CCD done in primary setting is comparable with TT-alone. Bilateral CCD should be done with thyroidectomy in PTC, otherwise the risk of residual diseases and subsequent recurrence is high. The long-term morbidity is comparable in experienced hands. © 2012 Sudhi Agarwal et al.