Risk factors for lateral lymph node metastasis of papillary thyroid carcinoma in children

Introduction: Lateral cervical lymph node metastases (LNM) for pediatric patients with papillary thyroid cancer (PTC) is a poor prognostic factor. We aimed to identify risk factors for lateral LNM. Methods: This retrospective study had included 48 pediatric patients with papillary thyroid cancer un-derwent total thyroidectomy and central cervical lymphadenectomy at K hospital from 2016 to 2020. Results: The number of patients in each T stage was as follows: 24 (50.0%) in stage 1, 9 (18.7%) in Stage 2, 8 (16.7%) in Stage 3, and 7 (14.6%) in Stage 4. Most of the patients had LNM with N1a and N1b rates of 83.3% and 62.5%, respectively. Lung metastases were observed at presentation in three patients (6.3%). Univariate analysis revealed that age ( p = 0.021), male ( p = 0.011), tumor size > 10 mm ( p = 0.002), multifocality ( p < 0.001), extrathyroidal extension ( p = 0.001) and central LNM ( p < 0.001) were factors that increase the risk of metastasis to lateral LNM. Conclusion: Approximately 62.5% of pediatric patients with PTC exhibited lateral LNM at the time of diagnosis. Our study confirmed that multifocality, maximum tumor diameter, extrathyroidal extension and central LNM were independent risk factors for lateral LNM in pediatric PTC. Level of Evidence: Level IV. (c) 2022 Published by Elsevier Inc.