Significant Number of Patients with Papillary Thyroid Carcinoma Will Have Macroscopic Nodal Disease

What are the characteristics of nodal disease in patients presenting with papillary thyroid carcinoma (PTC)?

Bottom line
Overall, 35% of patients presenting with papillary carcinoma harbor macroscopic nodal disease requiring therapeutic dissection. Results suggest that a significant proportion of patients will have nodal disease in the central compartment on initial presentation, especially younger patients, and ETE and tumor size are associated with macroscopic nodal disease.

Background: Well-differentiated PTC is the most common thyroid malignancy. It has a highly favorable prognosis, but also a high incidence of lymph node metastases. There is an important distinction between macroscopic (clinically apparent, present in 28% to 42% of PTC patients) and microscopic nodal disease that can affect clinical relevance and surgical management.

Study design: Retrospective chart review of 416 PTC patients who underwent a total of 487 surgeries for thyroidectomy and/or neck dissection (revision/primary) from January 2004 to June 2009 at a tertiary-care hospital.

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