چکیده (انگلیسی):

Background: Central lymph node dissection (CLND) in patients with papillary thyroid
microcarcinoma (PTMC) is still controversial. The aim of this study was to examine the risk
factors and the incidence of central lymph node metastases (CLNMs) in patients with PTMC
who underwent thyroidectomy and CLND.
Patients and methods: Between 2002 and 2013, 613 patients were enrolled who underwent
thyroidectomy with routine CLND for PTMC at the Korea University Medical Center, Ansan Hospital
and risk factors and the incidence of CLNM were analyzed. In addition, we also evaluated
the complications after thyroidectomy with CLND.
Results: Out of 613 patients, 239 (39.0%) were found to have CLNM. Male sex (p Z 0.012), tumor
size
0.5 cm (p Z 0.001), capsular invasion or extrathyroidal extension (p Z 0.029), and
multifocality (p Z 0.004) were independent risk factors for CLNM. Among the 69 patients who
had PTMC without these risk factors, CLNM was identified in 12 (17.4%). In this study group, two
(0.3%) had permanent recurrent laryngeal nerve injury, two (0.3%) had persistent hypocalcemia,
and two (0.3%) developed postoperative hemorrhage.
Conclusion: CLNM in PTMC is highly prevalent in male sex, tumor size
0.5 cm, extrathyroidal
extension, and multifocality. Even in PTMC patients without these risk factors, the incidence of
CLNM is rather higher than expected, and the complication rate of thyroidectomy with CLND is
acceptable. Thus, CLND should be considered in all patients with PTMC.