Multifocality is associated with central neck lymph node metastases in papillary thyroid microcarcinoma.

BACKGROUND

This study aimed to assess the predictive factor of multifocality to identify patients at high risk of central lymph node metastasis (CLNM).

PATIENTS AND METHODS

Papillary thyroid microcarcinoma patients who underwent total or hemi-thyroidectomy with effective unilateral or bilateral central lymph node dissection were enrolled.

RESULTS

Multifocality, age, sex, tumor size, extrathyroidal extension, and nodular goiter were significantly associated with CLNM. Multifocality was an independent predictor for CLNM in multivariate analysis. Compared with unifocal disease, the odds ratio for CLNM was 1.447 for patients with ≥2 tumor foci (<0.001) and 2.978 for patients with ≥3 tumor foci (<0.001). The significant association is at ≥3 foci diseases.

CONCLUSION

Multifocality with ≥3 tumor foci was an independent predictive factor for CLNM in papillary thyroid microcarcinoma. Multifocality should be assessed when selecting patients for prophylactic central neck lymph node dissection, and we speculate that patients with multifocality should undergo more radical treatment.