https://orcid.org/0000-0001-5248-9870
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Abstract
Purpose
To identify candidate factors for predicting high-volume lateral lymph node metastasis (LLNM) in papillary thyroid microcarcinoma (PTMC).
Methods
We retrospectively studied 2981 patients with PTMC who underwent thyroidectomy from 2013 to 2016. LLNM was identified by histopathology. Patients with different LLNM statuses were compared according to clinical, sonographic and pathological parameters. A multivariate logistic model was established to predict high-volume LLNM (number of metastatic lymph nodes >5).
Results
High-volume LLNM of PTMC was independently associated with age < 40 years (OR = 1.791, P = 0.023), male sex (OR = 2.401, p = 0.001), tumor size > 0.5 cm (OR = 4.839, p < 0.001), extrathyroidal extension (OR = 2.097, p = 0.007) and microcalcification (OR = 2.894, p = 0.002). These five factors were incorporated together to develop a multivariate analysis, which showed good predictive ability (AUC = 0.78, 95% CI 0.72–0.83), with a sensitivity of 80.0% and a specificity of 61.4%. Moreover, more level II or V lateral regions were involved in patients with high-volume LLNM than in those with small-volume LLNM (69.2% vs. 25.0%, p < 0.001; 10.8% vs. 4.7%, p < 0.001).
Conclusion
Multilevel LLNM tended to be more common in patients with PTMC who had high-volume LLNM. The high-volume LLNM rates of patients with PTMC with age < 40 years, male sex, tumor size > 0.5 cm, extrathyroidal extension and microcalcification were relatively higher than those without. These findings may be useful for identifying patients at higher high-volume LLNM risk who may require more aggressive treatment or intensive follow-up management.
Acknowledgements
Not applicable.
Disclosure statement
No potential conflict of interest was reported by the author(s).
Availability of data and material
The datasets generated during and/or analyzed during the current study are available from the corresponding author on reasonable request.
Ethics approval
This study was approved by the ethics committee of Peking Union Medical College Hospital. All procedures performed in the studies were in accordance with the 1964 Helsinki declaration and its later amendments or comparable ethical standards. Written informed consent for participation was not required for this study in accordance with the national legislation and the institutional requirements.