Possible prediction of patterns of cervical lymph node spread based on primary tumor location in papillary thyroid carcinomas

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Backround/aim: Papillary thyroid carcinomas (PTC) frequently metastasize to regional lymph nodes. Our purpose was to investigate the predictive role of tumor location for lymph node metastasis pattern in PTCs. Materials and methods: Medical records of 110 PTC patients were reviewed retrospectively. Tumor location was determined as upper, middle, and lower pole according to ultrasonography (USG) findings. The effects of age, sex, tumor size, and location on lymph node metastasis were investigated. Results: The series comprised 87% females (n = 96) and 13% males (n = 14). Forty-three patients had central neck metastasis (CNM) and 14 had lateral neck metastasis (LNM). Upper pole tumors (UPT) metastasized to the central neck (CN) at a lower rate (17.6%) than middle (40.0%) or lower (48.5%) poles overall (P = 0.104), while it was at a significantly lower rate (13.3%) in the PTC group (P < 0.05). UPTs (n = 17) metastasized to the lateral neck (LN) almost 2-fold more. It was observed that 3 of 4 UPTs spread directly to the LN without CNM. Conclusion: In our opinion, UPTs have propensity to demonstrate metastasis to LN rather than the CN in PTCs. Therefore, UPTs should be evaluated meticulously in terms of LNM. New studies could suggest that CN dissection is not performed for low-risk PTCs in UPTs.

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