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Cervical Lymph Node Dissection in Papillary Thyroid Cancer: Pattern and Predictive Factors of Regional Lymph Node Metastas

Guilherme Souza Silva, Paulo Roberto Savassi Rocha, Jose Maria Porcaro Salles, Gustavo Meyer Moraes and Alexandre Andrade Sousa

Background: Papillary thyroid carcinoma (PTC) exhibits a high index of cervical lymphatic dissemination. Methods: Retrospective study of 101 cases of PTC subjected to total thyroidectomy associated with cervical lymph node dissection. Results: The incidence of neck metastasis was 50.5%, and all the metastases wereipsilateral to the primary tumor. Although the participants with metastases (N+) hadmore dissected lymph nodes than the group without metastases (p = 0.01), the lymphnode size was not a determinant of malignancy (p=0.34). Uni and multivariate analyses showed tumor size ≥ 1.0 cm, angiolymphatic invasion, and multicentric diseases were associated with lymphatic dissemination (p < 0.05). Conclusions: Factors predictive of cervical lymph node metastasis were tumor size ≥ 1.0cm, multicentric disease and angiolymphatic invasion. All the metastases wereipsilateral to the primary tumor. Lymph node size was not a reliable predictor of thepresence or absence of metastasis.