Retrospective Study
Copyright ©The Author(s) 2022. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Clin Cases. Apr 26, 2022; 10(12): 3709-3719
Published online Apr 26, 2022. doi: 10.12998/wjcc.v10.i12.3709
Relationship between subgroups of central and lateral lymph node metastasis in clinically node-negative papillary thyroid carcinoma
Jing Zhou, Da-Xue Li, Han Gao, Xin-Liang Su
Jing Zhou, Da-Xue Li, Han Gao, Department of Thyroid and Breast Surgery, Chongqing Health Center for Women and Children, Chongqing 401120, China
Xin-Liang Su, Department of Thyroid and Breast Surgery, First Affiliated Hospital of Chongqing Medical University, Chongqing 400016, China
Author contributions: Zhou J and Li DX contributed equally to this work; Zhou J, Su XL and Gao H designed the research study; Zhou J, Li DX and Gao H performed the research; Su XL and Gao H contributed new analytic tools; Zhou J and Li DX analyzed the data and wrote the manuscript; all authors have read and approve the final manuscript.
Institutional review board statement: This study was reviewed and approved by the Ethics Committee of the First Affiliated Hospital of Chongqing Medical University. The research content and process of the project followed the international and national ethical requirements for biomedical research.
Informed consent statement: Patients were not required to give informed consent to the study because the analysis used anonymous clinical data that were obtained after each patient agreed to treatment by written consent.
Conflict-of-interest statement: All authors have no potential conflicts of interest to disclose.
Data sharing statement: No additional data are available.
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: https://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Xin-Liang Su, MD, PhD, Professor, Surgical Oncologist, Department of Thyroid and Breast Surgery, First Affiliated Hospital of Chongqing Medical University, No. 1 Youyi Road, Yuzhong District, Chongqing 400016, China. suxinliang@21cn.com
Received: September 1, 2021
Peer-review started: September 1, 2021
First decision: October 25, 2021
Revised: November 8, 2021
Accepted: March 6, 2022
Article in press: March 6, 2022
Published online: April 26, 2022
Processing time: 232 Days and 0.2 Hours
Core Tip

Core Tip: Lymph node metastasis (LNM) of papillary thyroid carcinoma (PTC) has a certain regularity. The pathway of PTC LNM can guide selective lymph node dissection (LND) for clinical surgeons, thereby overcoming the drawbacks of prophylactic LND; accurate surgery can be used to not only radically dissect lymph nodes but also reduce the incidence of complications. The results of our retrospective study found that the LNM pathway of PTC has a certain regularity. Prelaryngeal LNM is a predictor of ipsilateral level-II LNM. Pretracheal and ipsilateral paratracheal LNM are predictors of ipsilateral level-III and level-IV LNM. Therefore, for unilateral cN0-PTC patients with a tumor diameter > 2 cm and pretracheal or ipsilateral paratracheal LNM, LND at ipsilateral level III and level IV must be considered. When there is a tumor in the upper third of the thyroid with prelaryngeal LNM, LND at level II, level III and level IV must be considered.