The effect of tumor size on the risk of lymph node metastasis in differentiated thyroid cancer
Shaza Ahmed Samargandy, Saad J. Samargandy, Wejadan Mohammad Baabdullah, Ali Alhussain Alhazmi, Meshal Mohammed Alasiri, Samaher Saeed Hazzazi, Zahra Kadhem AbdulnabiABSTRACT
Context:
Lymph node metastasis (LNM) is one of the most important factors of persistent and recurrent disease in differentiated thyroid cancer (DTC).
Aims:
The aim of this study was to assess the association between tumor size and the risk of LNM.
Settings and Design:
A retrospective chart review of all patients with DTC over the age of 13 years who underwent lobectomy or total thyroidectomy with or without compartmental lymph node dissection, between 2018 and 2022 and had sufficient histopathological data. The study took place at King Abdulaziz University Hospital.
Subjects and Methods:
LNM was identified by histological examination and divided into central and lateral LNM. Logistic regression analysis was used to assess the association between tumor size (>2 cm vs. ≤2 cm) and the risk of LNM, adjusting for demographic and other histopathologic variables.
Results:
A total of 381 patients met the inclusion criteria and were included in this study. Patients with tumor size >2 cm comprised 49% of the sample, and those with LNM comprised 37% (n = 76 for central LNM and n = 66 for lateral LNM). After adjusting for age, sex, extrathyroidal extension, vascular invasion, tumor multifocality, and distant metastasis, tumor size was not associated with LNM (odds ratio [OR] = 1.29, 95% confidence interval [CI]: 0.77–2.17, P = 0.33). When limiting the outcome to only lateral LNM, tumor size was still not associated with lateral LNM (OR: 1.29, 95%CI: 0.77–2.17,P = 0.33).
Conclusions:
Tumor size is not associated with LNM. LNM is mainly associated with the presence of other aggressive histological features. Tumor size should not solely influence the operative decisions for prophylactic lymph node dissection.