Predictive Factors Of Skip Metastasis To Lateral And Leaping Central Lymph Node In Papillary Thyroid Carcinoma

Objective:This paper aims to retrospectively analyze the regularity and risk factors of skip metastasis(central lymph node negative and lateral lymph node positive)in papillary thyroid carcinoma(PTC).Methods:A total of 521 PTC patients underwent total thyroidectomy and central plus lateral lymph node dissection at The First Affiliated Hospital of Chongqing Medical University from January 2013 to December 2016.Clinicopathological characteristics of the patients were collected and analyzed.Results:Skip metastasis rate of papillary thyroid carcinoma was 8.3%(43/521).Tumors in the upper lobe(OR=3.401,95%Cl:1.770-6.536;P=0.001)and in the lateral part(OR=3.424,95%CI:1.182-9.920;P=0.023)of the thyroid,as well as ages above 45(OR=2.856,95%CI:1.488-5.482;P= 0.002),were independent risk factors for skip metastases for this disease.Clinically node-negative(cN0)PTC patients with tumors in the upper lobe had higher possibility of skip metastases than those of clinically involved lateral neck nodes.(cN1b)patients(P=0.022).Conclusion:Skip metastasis of PTC is not uncommon.Thus,preoperative clinical assessment and imaging examination for lateral lymph node is necessary,especially for PTC patients who are above 45 years old and with tumors in the upper lobe and/or unilateral area of thyroid.The lateral lymph node dissection should be performed when necessary.