Clinically Significant Central Lymph Node Metastasis is Not Common in Patients with Clinically N0 Papillary Thyroid Carcinoma on Both Ultrasonography and Computed Tomography (CT)
Authors' conclusion
Most LNs confirmed after CLND in cN0 PTC patients assessed by USG and CT were either metastasis-free or classified as low-risk metastatic LNs. Furthermore, the majority of metastatic LNs were small in size, typically measuring <1 cm.
Study context
- Population
- Patients with clinically node-negative papillary thyroid carcinoma (PTC) (no suspicious metastatic lymph node (LNs) on preoperative ultrasonography (USG) and neck CT) who underwent thyroidectomy with prophylactic central lymph node dissection (p-CLND), January 2000 to September 2022
- Participants
- 3,002 patients
- Outcome
- Central LN metastasis status
Main finding
As reported in the abstract
- Central LN metastases
- 1194 (39.7%)
- No central LN metastases
- 1808 (60.3%)
- Intermediate-risk metastases
- 507 (16.9%)
- Low-risk LN metastases (<2 mm, ≤5 metastatic LNs)
- 610 (20.3%)
- Low-risk LN metastases or no central LN metastases
- 2428 (80.5%)
- High-risk metastases
- 77 (2.5%)
Observational data: associations, not effects.
Further findings
Disease recurrence · median follow-up 4.52 (IQR: 1.6-7.5) years — between No LN metastases and Low-risk LN metastases · across the three groups
P = 0.012
Size of central LN metastases among 584 with intermediate-/high-risk metastases
- Central LN metastases <1 cm
- 577 (98.8%)
- Central LN metastases ≥1 cm
- 7 (1.2%)
Factors independently associated with intermediate-/high-risk central LN metastases
- Age <55 years, OR
- 2.29
- Male sex, OR
- 2.33
- Tumor size >1 cm on USG, OR
- 1.94
- Extrathyroidal extension on CT, OR
- 1.53
- p < 0.001 for all factors
Original publication
Clinically Significant Central Lymph Node Metastasis is Not Common in Patients with Clinically N0 Papillary Thyroid Carcinoma on Both Ultrasonography and CT. Thyroid. Published 31 March 2025. doi:10.
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