Anatomical Patterns of Nodal Spread in Unilateral Papillary and Medullary Thyroid Cancer
Authors' conclusion
These histopathological findings, which need to be interpreted in light of the respective tumor biology, offer an unprecedented glimpse at the metastatic patterns of unilateral PTC and MTC.
Study context
- Population
- Patients with unilateral papillary thyroid cancer (PTC) or medullary thyroid cancer (MTC) who had thyroidectomy with at least ipsilateral central neck dissection, November 1994–January 2024, tertiary referral centre
- Participants
- 833 vs 640
- Exposure
- Unilateral PTC vs unilateral MTC
- PTCn = 833
- MTCn = 640
- Outcome
- Patterns of central and lateral neck node involvement
Methodological detailsretrospective correlative analysis, tertiary referral centre, surgical specimens
- Retrospective correlative analysis
- Tertiary referral centre
- Surgical specimens
Main finding
As reported in the abstract
- Simultaneous presence or absence of node metastases in ipsilateral central and lateral compartments, PTC
- 76.6-78.1%
- Both node positive, PTC
- 27.0-54.7%
- Both node negative, PTC
- 23.4-49.6%
- Simultaneous presence or absence of node metastases in ipsilateral central and lateral compartments, MTC
- 77.3-80.0%
- Both node positive, MTC
- 26.6-33.2%
- Both node negative, MTC
- 44.1-53.4%
- Only one ipsilateral compartment node positive, PTC
- 21.9-23.4%
- Only one ipsilateral compartment node positive, MTC
- 20.0-22.7%
- Ipsilateral central but not lateral node positive, PTC
- 8.8-16.9%
- Ipsilateral central but not lateral node positive, MTC
- 8.6-8.8%
- Ipsilateral lateral but not central node positive (skip), PTC
- 6.5-13.1%
- Ipsilateral lateral but not central node positive (skip), MTC
- 11.3-14.1%
- Lateral involvement sparing central neck in node-positive MTC vs node-positive PTC
- 24.2-25.2% vs. 12.9-17.1%
Observational data: associations, not effects.
Further findings
Number of ipsilateral central node metastases and spread
- Greater numbers of ipsilateral central node metastases associated with more frequent ipsilateral lateral, contralateral central and contralateral lateral involvement
Tumour diameter
- Tumour diameter intensified nodal spread without changing nodal spread patterns
Original publication
Anatomical Patterns of Nodal Spread in Unilateral Papillary and Medullary Thyroid Cancer. Thyroid. Published 21 May 2024. doi:10.
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