Analysis Of Predictor Factors For Lateral Neck Metastasis In Medullary Thyroid Carcinoma

Objective:The aim of the study is to investigate the predictive factors of lateral lymph node metastasis in medullary thyroid carcinoma,and provide a proof for selection of surgical treatment.Methods:Patients with medullary thyroid carcinoma who had undergone lateral lymph node dissection from January 2005 to March 2019 were retrospectively study.Clinicopathological features such as the gender,age,preoperative CEA and calcitonin levels,tumor size and the number of central lymph node metastasis were analyzed.Results:40(69%)patients were positive for ipsilateral lateral lymph node metastasis of all the 58 patients.Univariate analysis showed that age(P=0.005),tumor diameter(P=0.041),and central lymph node metastasis(P<0.001)were related factors.Preoperative serum CEA>180ng/ml was associated with ipsilateral lateral lymph node metastasis(P=0.009),and preoperative serum calcitonin had no correlation with lateral lymph node metastasis.The number of central lymph node metastasis was a independent predictive factor for ipsilateral lateral lymph node metastasis(P<0.001),and the positive rate was positively correlated with the increasing number of central lymph node metastasis.Conclusion:The number of central lymph node metastases can be used as predictor factors of medullary thyroid carcinoma.For patients with MTC with the number of central lymph node metastasis>3,ipsilateral lateral neck dissection should be performed prophylactically.For patients with MTC with preoperative CEA levels>180 ng/ml,age>49 or the diameter of tumor>3cm,ipsilateral lateral neck dissection is advised.