Central lymph node metastasis is an important prognostic factor in patients with papillary thyroid microcarcinoma.

Abstract

Papillary thyroid microcarcinoma (PTMC) has been increasing, without a consensus

for the management of this condition. In the present study, we analyzed the

clinicopathological features of patients with PTMC to examine the impact of

initial therapy and establish appropriate treatment. A total of 2,018 patients

with PTMC were enrolled at a single university hospital. Of them, 1,245 patients

(61.8%) underwent total thyroidectomy, and 1,838 patients (91.3%) underwent

central lymph node (LN) dissection. Five-and 10-yr recurrence rates were 3.2% and

4.6%, respectively. In univariate analysis, the prognostic factors for recurrence

were N stage, the number of LN metastases, and extrathyroidal extension. However,

multivariate analysis revealed LN metastases and N stage as the only significant

prognostic factors after adjusting for confounding factors (P < 0.001).

Additionally, multivariate analysis of a subgroup consisting of PTMC patients

without N1b revealed the number of central LN metastases as the only significant

factor. Therefore, intraoperative examination for central LN metastasis may

discriminate high or low risk group.