[Central compartment lymph node metastasis in cN0 papillary thyroid carcinoma].

OBJECTIVE

To evaluate the incidence and the predictive factors for the metastasis of central compartment lymph nodes (level VI) in clinically node-negative (cN0) papillary thyroid carcinoma (PTC).

METHODS

One hundred and eight patients with cN0 PTC underwent neck dissection for level VI between January 2003 and December 2006 were followed up and analyzed retrospectively. Univariate analysis with the χ² test was used to analyze the statistical correlation between central compartment lymph nodes metastasis and the other clinical factors. Multiple Logistic regression analysis was used to identify the multivariate correlates of central compartment metastasis. Kaplan-Meier method was used to calculate the accumulative survival rate, lateral neck recurrence and metastasis rate.

RESULTS

Metastasis rate in level VI was 59.2% (64/108). Age below 45, tumor size > 3 cm and extracapsular spread were independent predictive factors for the metastasis in level VI (odds ratio were 5.514, 5.610 and 3.122, P < 0.05, respectively). There were low incidence of postoperative complications, 2 cases with transient nerve palsy (1.8%), 5 cases with transient hypoparathyroidism (4.6%) and 1 case with permanent hypoparathyroidism (0.9%). Six cases with ipsilateral neck recurrence, 1 case died. The 5-year lateral neck recurrence rate and accumulative survival rate were 4.8% and 99.1% respectively.

CONCLUSION

Metastasis in level VI in the patients with cN0 PTC is common and selective neck dissection is necessary for the patients.