ArticleFrontiers in oncology2024
Risk factors associated with lymph node metastasis in papillary thyroid cancer: a retrospective analysis based on 2,428 cases.
Article in Frontiers in oncology, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 5 papers.
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5 citing papers in PubMed.
- Papillary thyroid carcinoma in a patient with long-standing chronic lymphocytic leukemia: A case report.Oncology letters · 2026Article
- Development and Validation of a Picture Archiving and Communication System-Integrated Artificial Intelligence for Predicting Cervical Lymph Node Metastasis in Papillary Thyroid Carcinoma.Journal of imaging informatics in medicine · 2026Article
- Interpretable machine learning distinguishes skip from continuous metastasis in N1b papillary thyroid carcinoma.Scientific reports · 2026Article
- Development of a clinically applicable prediction tool for lymph node metastasis in papillary thyroid carcinoma using lasso-logistic regression.BMC cancer · 2026Article
- Dual nomograms to predict central and lateral cervical lymph node metastasis in papillary thyroid carcinoma with Hashimoto's thyroiditis: a two-cohort study.Frontiers in endocrinology · 2026Article
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Abstract
Background: Papillary thyroid cancer (PTC) with lymph node metastasis (LNM) is associated with an increased risk of postoperative recurrence. Understanding the clinical characteristics of PTC patients can help surgeons assess the likelihood of LNM. This study aims to identify risk factors for LNM in PTC patients. Methods: We retrospectively analyzed clinical data from 2,428 patients diagnosed with PTC who underwent initial thyroid surgery in our single center. Risk factors related to central lymph node metastasis (CLNM), lateral lymph node metastasis (LLNM), and skip metastasis were investigated by univariate and multivariate binary logistic regression analyses. Results: Univariate analysis revealed that the following factors were associated with an increased likelihood of CLNM (P<0.05): male gender, age < 45 years, maximal axial diameter (MAD) > 1 cm, body mass index (BMI) ≥ 28 kg/m² and multifocality. Univariate analysis also revealed that patients with age < 45 years, MAD > 1 cm, BMI ≥ 28 kg/m², multifocality, and CLNM demonstrated a higher propensity for LLNM (P<0.05). Lower pole tumors were more likely to have CLNM than upper pole tumors, while upper pole tumors were more prone to present LLNM (P<0.05) and skip metastasis (P<0.05). Multivariable binary logistic regression analysis identified that gender (odds ratio [OR], 1.732; 95% CI, 2.113-2.577; P < 0.001), age (OR, 1.905; 95% CI, 1.596-2.273; P < 0.001), MAD (OR, 4.639; 95% CI, 3.639-5.913; P < 0.001), and multifocality (OR, 1.860; 95% CI, 1.453-2.381; P < 0.001) were independent risk factors for CLNM and MAD (OR, 5.289; 95% CI, 3.777-7.404; P<0.001), multifocality (OR, 1.858; 95% CI, 1.248-2.766; P=0.002), and CLNM (OR, 5.030; 95% CI, 3.347-7.561; P<0.001) for LLNM. Conclusion: Despite the overall postoperative recurrence rate in PTC patients is low, identifying risk factors such as male gender, age < 45 years, MAD > 1 cm, multifocality, and CLNM can help predict LNM. In specific cases, selective lymphadenectomy in the central or lateral neck area may be warranted.
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