[The characteristics of papillary thyroid cancer lymph node metastasis and the clinical significance of central region cervical lymph node dissection].

OBJECTIVE

To explore the necessity of the central region cervical lymph node dissection for patients with papillary thyroid carcinoma.

METHODS

Clinical data of 457 papillary thyroid cancer patients underwent bilateral thyroidectomy with cervical lymph node excision from June 2003 to September 2007 were retrospectively reviewed. There were 86 male patients and 371 female patients. The age was 17 to 73 years old.

RESULTS

There were no death for operation or in hospital. The total rate of central region cervical lymph node (VI region) metastasis was 59.1% (270/457), and bilateral metastasis was 42.2% (114/270). The total rate of III + IV region cervical lymph node metastasis was 29.8% (136/457). For unilateral papillary thyroid cancer, when tumor diameter over 1 cm and tumor breaking through thyroid caps, the central region cervical lymph node metastasis was 64.5% (178/276) and 81.6% (120/147) respectively. When the tumor diameter < or = 1 cm and tumor confining in thyroid, central region cervical lymph node metastasis was 23.4% (11/47) and 39.2% (69/176) respectively. There were 5 cases with lymph node jumping metastasis. During the follow-up of 7 to 59 months, 1 case died of lung metastasis. Four cases occurred local recurrence, 3 cases occurred distant metastasis. There was no case of hypothyroidism under the thyroxine replacement therapy.

CONCLUSIONS

For papillary thyroid cancer, the most common cervical lymph node metastasis is central region. It is necessary to dissect bilateral central region lymph node following the original surgical procedures.