Cancer Management and Research (Jul 2021)
Effect of Tumor Location on the Risk of Bilateral Central Lymph Node Metastasis in Unilateral 1-4 cm Papillary Thyroid Carcinoma
Abstract
Nan Liu, Bo Chen, Luchuan Li, Qingdong Zeng, Lei Sheng, Bin Zhang, Bin Lv Department of Thyroid Surgery, General Surgery, Qilu Hospital of Shandong University, Jinan, 250012, Shandong, People’s Republic of ChinaCorrespondence: Bin LvDepartment of Thyroid Surgery, General Surgery, Qilu Hospital of Shandong University, Jinan, 250012, Shandong, People’s Republic of ChinaEmail [email protected]: Papillary thyroid carcinoma (PTC) has a high incidence of lymph node metastasis (LNM). Our aim was to determine whether tumor location is a useful feature to predict bilateral central lymph node metastasis (CLNM) in unilateral 1– 4 cm PTC.Patients and Methods: Data on unilateral 1– 4 cm PTC patients from 2016 to 2019 were collected retrospectively. The clinical and pathological characteristics of the tumors and lymph nodes were analyzed statistically.Results: The mean patient age was 49.1± 12.3 (23– 73) years, and the majority were women (n=1334, 75.4%). A total of 1767 patients were analyzed, and 256 (14.5%) had bilateral CLNM. Tumor location was an independent risk factor in predicting bilateral CLNM (p< 0.001). The odds of bilateral CLNM were the highest in the near isthmus (OR 6.452, 95% CI: 3.658– 11.379, p< 0.001). In a multivariate regression model adjusting for other risk factors, near-isthmus tumors had the highest risk of bilateral CLNM (OR 7.319, 95% CI: 3.844– 13.933, p< 0.001), followed by lower lobe tumors (OR 2.338, 95% CI: 1.315– 4.155, p=0.004) and middle lobe tumors (OR 1.845, 95% CI: 1.035– 3.291, p=0.038), compared to upper lobe tumors.Conclusion: Tumor location is an independent risk factor in predicting the risk of bilateral CLNM. Near-isthmus tumors carry the highest risk of bilateral CLNM.Keywords: papillary thyroid carcinoma, location, predictive factor, lymph node metastasis
