Endocrine Abstracts

Introduction: Papillary carcinoma is the most common histological type of thyroid carcinomas. Lymph node involvement is an important prognostic factor. But its management remains uncodified.

Objective: The aim of our study was to identify the predictive factors of lateral lymph node metastases in papillary thyroid carcinoma.

Methods: This is a retrospective study including 96 patients operated on for papillary thyroid carcinoma at our department from 2001 to 2021 with a minimum postoperative follow-up of two years with clinical, biological and ultrasound control.

Results: Our study included 23 patients with lateral lymph node metastases with a mean age of 42 years, slightly lower than that of group without lateral metastasis (48 years). The sensitivity and the specificity of neck ultrasound in identifying lateral metastatic nodes were 71% and 83% respectively. Total thyroidectomy was performed in all cases. Central neck dissection was performed in 59 cases. Metastatic nodes were found in 47% of cases. Lateral neck dissection was done either simultaneously (n=21) or 12 and 18 months later (n=2). All patients received additional radioactive iodine treatment with an average dose of 200 mci. In our study, we identified tumor capsular invasion (P=0.04) and recurrent lymph node invasion (P=0.02) as independent factors of lateral lymph node metastases.

Conclusion: Lymph node involvement is a determining prognostic factor in papillary thyroid carcinoma. Central dissection is required if the cancer is diagnosed before or during the surgery. In the presence of metastatic nodes or other risk factors, preventive or curative lateral dissection should be discussed.