Central Lymph Node Metastasis: Is It a Reliable Indicator of Lateral Node Involvement in Papillary Thyroid Carcinoma?

The purpose of the present study was to evaluate the reliability of central lymph node metastases in predicting lateral node involvement in papillary thyroid carcinoma (PTC). This retrospective study consists of 121 patients with PTC who underwent ipsilateral selective neck dissection. The quantitative relationship between central and lateral lymph node metastases (LNM) was analyzed. A total of 86 patients (71.1%) had pathologically proven LNM; 55 patients had LNM in both the central and lateral compartments, 22 patients had only central LNM, and 9 patients had skip metastasis to lateral nodes. The sensitivity of central node involvement to predict lateral LNM was 85.9%, the specificity was 61.4%. The presence of two or more positive central nodes was associated with a high incidence of lateral LNM (70-93.3%), when compared with none (20.5%) or one (47.4%) positive central node. The node status of the central compartment is moderately predictive of that of lateral compartment. The presence of two or more positive central nodes may be of value in predicting lateral node involvement.