Pattern and Predictive Factors of Regional Lymph Node Metastasis in Papillary Thyroid Carcinoma: a Prospective Study

Background: Most of the reports about lymph node (LN) metastasis in papillary thyroid carcinoma (PTC) are retrospective studies.

Methods: We prospectively evaluated the pattern and predictive factors of LN metastasis of 176 patients with PTC who underwent total thyroidectomy and bilateral central LN dissection with or without therapeutic lateral LN dissection.

Results: Ipsilateral central LNs were involved even in early T classification, and contralateral central LNs were infrequently involved even in late T classification. Most of the lateral LN metastases were in levels II, III, and IV. Male sex was predictive of LN metastasis. Ipsilateral central LN metastasis and central LN metastasis were associated with contralateral central LN metastasis and lateral LN metastasis, respectively.

Conclusions: Ipsilateral central neck dissection is recommended for all PTC patients. Careful inspection for LN metastasis should be performed when evaluating male patients with PTC, and if central LNs are involved, carefully inspect lateral LNs.