Factors Affecting the Risk of Lymph Node Metastasis in Papillary Thyroid Cancer

Abstract

Aim: Papillary thyroid cancer is the most common type of differentiated thyroid carcinoma and lymph node metastasis is common. Lymph node metastasis is an important prognostic factor for disease recurrence. The aim of this study was to evaluate the predictive factors affecting lymph node metastasis. Materials and Methods: The files of 34 patients who underwent central and / or lateral neck dissection with the diagnosis of papillary thyroid cancer (PTC) between June 2017 and June 2020 were retrospectively analyzed from the hospital database. The relationship of age, gender, thyroid function tests and antibodies, tumor size, lymphovascular invasion and multicentricity factors with lymph node metastasis was evaluated. Results: The most common surgery performed according to the clinical conditions of the 34 patients included in the study was central neck dissection with total thyroidectomy (64.7%), and a total of 12 (35.3%) patients underwent lateral neck dissection in addition to central dissection. In the central node positive patient group, statistically significantly more multicentric tumors and lymphovascular invasion were observed (p = 0.033; p = 0.050). In the lateral lymph node positive patient group, statistically significantly more central metastases and lymphovascular invasion were observed (p = 0.007; p = 0.007). Regardless of the lymph node regions, statistically significantly more LVI positivity was observed in node-positive patients compared with node-negative patients (p = 0.025). Conclusion: In PTC patients, preoperative lymph node metastasis status should be staged by clinical and imaging methods, taking into account predictive risk factors, and the lymph node dissection method and the method should be determined in order to prevent recurrence and reduce re-operations.