Predictive factors for non-small-volume central lymph node metastases (more than 5 or ≥ 2 mm) in clinically node-negative papillary thyroid carcinoma

The benefits of prophylactic central neck dissection (pCND) for treating patients with clinical node-negative (cN0) papillary thyroid carcinoma (PTC) remain controversial. Lymph node metastases have been strongly associated with local recurrence and low survival, especially in PTC patients with 5 or more or ≥2 mm metastatic lymph nodes. The following study investigates the incidence and risk factors of more than 5 or ≥2 mm metastatic lymph nodes in the central compartment. A total of 611 patients with cN0 PTC were retrospectively analyzed. Cervical lymph nodes were harvested, and the size of metastatic lymph nodes was consequently analyzed. Non-small-volume central lymph node metastases (NSVCLNM), defined as more than 5 or ≥2 mm metastatic lymph nodes) were detected in 67 (11.0%) patients. Male gender, age ≤36 years, multifocal lesions, extrathyroidal extension, and tumor size > 0.85 cm were independent risk factors for NSVCLNM in cN0 PTC. The sensitivity and specificity of having ≥3 risk factors for predicting NSVCLNM was 46.3% and 86.8%, respectively. These findings suggest that pCND is a suitable treatment strategy for cN0 PTC patients with 3 or more risk factors for NSVCLNM.