Large-volume lymph node metastasis
(LNM) has been believed to be an important predictor for recurrence
in papillary thyroid microcarcinoma
(PTMC). However, the clinical predictors for large-volume LNM have yet to be established. This study aimed to determine clinical predictors for large-volume LNM in clinically node-negative PTMC.
A total of 947 clinically N0 PTMC patients who received total thyroidectomy with lymph node dissection and radioiodine therapy were included. Based on the LNM status, they were divided into two groups: large-volume LNM and small-volume LNM including those patients without LNM. The association between age
, gender and other clinical factors and large-volume LNM were investigated. The recurrence
-free survival was also compared among these groups.
We found that male
gender [odds ratio (OR) = 1.865, P
= 0.015], young age
(OR = 2.743, P
< 0.001) and extrathyroid extension (OR = 5.352, P
< 0.001) were independent predictors for high prevalence of large-volume LNM. Young (<40 years) and male
patients tended to have large-volume LNM with the highest prevalence of 17.20%, whereas old (≥55 years) and female patients had the lowest prevalence of 2.02%. After median follow-up of 71 months, the recurrence
rate was significantly higher for large-volume LNM compared with small-volume LNM (15.48 vs 0.72%, P
< 0.05). Large-volume LNM status was significantly associated with decreased recurrence
-free probability, while small-volume LNM had little effect on the recurrence
This study showed that in clinically node-negative PTMC, young male
patients had a greater incidence of large-volume LNM.