Introduction and purpose: More than 90% of differentiated thyroid cancers are papillary thyroid cancer (PTC). Lymph node metastasis is common in PTC and has been reported to have no effect on prognosis. The risk of cervical metastasis is high in the presence of clinicopathologic factors including extrathyroidal extension, multifocality and lymphovascular invasion. In this study, it was aimed to evaluate the clinicopathological features of lymph node metastasis development.
Materials and methods: Patients with papillary thyroid carcinoma diagnosed between 1995 and 2016 were retrospectively reviewed. Patients who previously had another cancer story were excluded from the study. The demographic characteristics and pathology findings (histopathology, tumor size, lymph node metastasis, lymphovascular invasion, multifocality, capsule invasion, bilaterality) and antiTG, antiTPO values were compared in patients with and without cervical lymph node metastasis.
Results: In 419 papillary thyroid cancer patients, 52 lymph node metastases were detected. Lymphovascular invasion was present in 24 patients and capsule invasion was present in 104 patients. Extrathroidal extension was present in 32 patients. In logistic regression analysis, age (<45 years old (P<0.001 OR:4.193)), lymphovascular invasion (P<0.001 OR:7.762), capsule invasion (P<0.002 OR:3.054), extrathyroidal extension (P<0.001 OR:6.450) and bilaterality (P <0.001 OR: 0.217) involvement were significantly associated with cervical lymph node metastasis.
Discussion: We found that the risk of cervical lymph node metastasis was high in the presence of extrathyroidal extension, multifocality and lymphovascular invasion. In contrast to previous reports, the risk was found to be high for the age group lower than 45. Clinically, lymph node metastasis does not develop in all patients, knowing risk factors of cervical lymph node metastasis can determine the operation type, the treatment and the follow-up.
20 - 23 May 2017
European Society of Endocrinology