The number of positive lymph nodes in the central compartment has prognostic impact in papillary thyroid cancer

Central compartment lymph node (CCLN) metastasis in papillary thyroid cancer (PTC) is associated with higher risk of loco-regional recurrence and distant metastasis. This study evaluated the prognostic implication of the number of metastatic CCLN in PTC. Prospective data collection on 91 patients with PTC who underwent total thyroidectomy and CCLN dissection with or without lateral neck dissection between January 2005 and December 2010 was made. Number of positive CCLN was correlated with known prognostic factors (age, gender, tumour size, extrathyroidal extension and lateral node metastasis). Patients were divided into three groups according to the number of positive CCLN: group A = 0 (n = 35); B = 1-2 nodes (n = 32) and C = > 3 nodes (n = 24). The risk of lateral compartment disease increased in parallel with the number of positive CCLN (31 vs. 50 vs. 75 % in groups A-B-C, respectively; p < 0.004). Gender/age/tumour size/extrathyroidal extension did not correlate with number of positive CCLN. The increasing number of positive CCLN did not influence post-ablation iodine uptake (1.25 vs. 1.14 vs. 2.63 %) and correlated with mean thyroglobulin values at 1-year post-ablation (12.3 vs. 42.3 vs. 91.48 mu g/L) The number of CCLN metastasis is a risk factor for lateral compartment disease with no correlation with other prognostic markers.