Predictors of lymph nodes posterior to the right recurrent laryngeal nerve metastasis in patients with papillary thyroid carcinoma A retrospective study

The aim of this study was to identify the risk factors associated with lymph nodes posterior to the right recurrent laryngeal nerve (LN-prRLN) metastasis in patients with papillary thyroid carcinoma (PTC). A total of 81 PTC patients who underwent total/near-total thyroidectomy with LN-prRLN dissection in the Department of General Surgery at Guangdong General Hospital between June 2015 and August 2016 were assessed retrospectively. The relations of LN-prRLN metastasis with clinicopathologic characteristics of PTC were analyzed by univariate and multivariate logistic regression. The incidence of LN-prRLN metastasis in patients with PTC was 51.9% (42 of 81 cases). Univariate analysis showed that lateral LN metastasis (P=.005), VIa central LN metastasis (P=.000), pathologic tumor size (P=.000), capsular invasion (P=.002), and extrathyroidal invasion (P=.018) (P<.05) were significantly associated with the increased incidence of LN-prRLN metastasis in PTC. No significant correlations were found between LN-prRLN metastasis and other variables such as gender (P=.056), age (P=.448), clinical N stage (cN) (P=.063), tumor location (P=.336), tumor site (P=.909), right tumor existence (P=.793), and multifocality (P=.381). Multivariate logistic regression analysis revealed that VIa central LN metastasis (OR: 4.490, P=.027) was independent risk factors of LN-prRLN metastasis in patients with PTC. LN-prRLN metastasis is often indentified in patients with PTC. VIa central LN metastasis is an independent predictors of LN-prRLN metastasis, which allow for selective LN-prRLN dissection in patients with PTC.