Predicting factors for central or lateral lymph node metastasis in conventional papillary thyroid microcarcinoma

Background: Optimal management for papillary thyroid microcarcinoma (PTMC) remains controversial. The purpose of this study was to explore risk factors predictive of cervical lymph node metastasis in conventional PTMCs. Methods: Conventional PTMC patients (n = 2,404) undergoing surgery between 2010 and 2017 were grouped and analyzed according to the positivity of cervical lymph node. Results: Central lymph node (CLN) metastases and lateral lymph node (LLN) metastases were observed in 915 (38.1%) and 184 (7.7%) cases, respectively. Multivariate analysis found that male (odds ratio [OR] = 1.974, p < 0.001), younger age (OR = 1.601, p < 0.001), tumor size (OR = 1.935, p < 0.001), extrathyroidal extension (ETE) (OR = 1.647, p < 0.001), multifocality (OR = 1.416, p < 0.001), and intrathyroidal spreading (OR = 3.355, p 0.001) predicted increased CLN metastasis. In particular, younger age, multifocality, and intrathyroidal spreading were signi ficantly associated with a high number of CLN metastases (n 5). The presence of CLN metastasis was strongly associated with LLN metastasis (OR = 5.426, p < 0.001). Conclusion: Male, younger age, tumor size, ETE, multifocality, and intrathyroidal spreading predict increased CLN metastasis in PTMCs. In patients with suspicious lateral lymphadenopathy, the presence of CLN metastasis is independently associated with LLN metastasis. (C) 2019 Elsevier Inc. All rights reserved.