The aim of this study was to evaluate the correlation between central lymph node (CLN)
metastasis and Clinicopathological characteristics of
papillary thyroid cancer (PTC). In addition, we investigated the incidence and risk factors for ipsilateral and contra lateral CLN
metastasis in unilateral PTC and the appropriate surgical extent for CLN dissection. A prospective study of 143 patients with unilateral PTC who underwent total
thyroidectomy and prophylactic bilateral CLN dissection was conducted. Of 143 patients, 58 had CLN
metastases. The rate of CLN
metastasis was considerably higher in cases of maximal
tumor size > 1 cm (P < 0.0001; OR 5.81). Ipsilateral CLN
metastasis was detected in 41% of cases of unilateral PTC, and contra lateral CLN
metastases was found in 14% of cases where as bilateral CLN
metastases in 8% of cases. The rate of contra lateral CLN
metastasis was considerably higher in cases of PTC with a large
tumor size (≥ 1 cm) (P = 0.0003; OR = 0.144) and with ipsilateral CLN
metastasis (P = 0.0002; OR 0.12).
Tumor size > 1 cm was independent risk factors for CLN
metastasis. Maximal
tumor size > 1 cm and presence of ipsilateral CLN macro
metastasis were independent risk factors for contra lateral CLN
metastasis. Therefore, both ipsilateral and contra lateral CLN dissections should be considered for unilateral PTC with a maximal
tumor size > 1 cm or presence of ipsilateral CLN macro
metastasis.