Pattern and Treatment of Papillary Thyroid Carcinoma with Cervical Lymph Node Metastasis

BACKGROUND AND OBJECTIVES: Cervical lymph node metastasis develops in approximately 30% to 80% of patients with papillary thyroid carcinoma. In papillary thyroid carcinoma, lymph node metastasis at presentation do not seem to adversely affect survival, but do increase the risk of loco-regional recurrence. The management of cervical metastasis in thyroid papillary carcinoma ranges from selective removal to a formal comprehensive neck dissection. In this study, we analyzed the pattern of cervical lymph node metastasis and the impact of prognostic variables in oder to plan how to manage the cervical lymph node metastasis in patients with papillary thyroid carcinoma. SUBJECTS AND METHOD: The clinical records and pathological reports of 114 patients who underwent surgery for thyroid papillary carcinoma at the Department of Otolaryngology-Head and Neck Surgery, Hanyang university from 1996 to 2002 were analyzed retrospectively. RESULTS: Cervical nodal metastasis was found in 57 (50.0%) patients. Occult metastasis was found in 26 (22.8%) patients. Cervical lymph node metastasis was most frequently noted in the level VI (38.6%). The size of primary tumor and extrathyroidal invasion were associated with cervical metastasis. CONCLUSION: Based on our results, it might be suggested that elective central neck dissection is needed for patients with papillary thyroid carcinoma which is larger than 35mm or has extrathyriodal extension