[Necessity of central lymph node dissection in management of papillary thyroid microcarcinoma].

OBJECTIVE

The objective of this study was to identify the risk factors for central lymph node metastasis (CLNM) of papillary thyroid microcarcinoma(PTMC) and to explore the necessity of central lymph node dissection (CLND).

METHOD

Clinical data of 85 patients with PTMC, who had undergone surgical treatment between January 2004 and May 2012, were retrospected. Risk factors for CLNM were identified by univariate analysis and multivariate analysis,which can provide the basis for elective performance of CLND.

RESULT

Of 85 patients,66 patients underwent ipsilateral CLND,while 19 patients received bilateral CLND. Concurrent cervical lymph node dissection was performed in 3 patients. The incidence of central and cervical lymph node metastasis was 38.8% and 3.53%, respectively. Univariate analysis showed that CLNM was correlated with tumor size > 5 mm, extrathyroidal extension, multifocality, bilaterality and intraoperatively suspected lymph node, but not related to gender and age. Upon multivariate analysis, tumor size > 5 mm (OR = 3.862, P < 0.05) and extrathyroidal extension (OR = 3.885, P < 0.05) were independent risk factors for CLNM.

CONCLUSION

Patients presenting tumor size > 5 mm and/or extrathyroidal extension may have an increased risk of central lymph node metastasis,and it is necessary to perform central lymph node dissection for them.