Predictive Factors for Different Subgroups of Central Lymph Node Metastasis in Unilateral Papillary Thyroid Carcinoma

<b><i>Aims:</i></b> We aimed to investigate the incidence rates and risk factors for different subgroups of central neck lymph node (LN) metastasis (prelaryngeal, ipsilateral paratracheal, pretracheal, and contralateral paratracheal) in unilateral papillary thyroid carcinoma (PTC) patients with clinically negative neck nodes (cN&#8320;). <b><i>Methods:</i></b> We evaluated 184 patients from 2007 to 2009. The relationships between different subgroups of LN metastasis and clinical pathological factors were analyzed. <b><i>Results:</i></b> The incidence rates of different central LN metastases were diverse. Multivariate analysis indicated that lymphovascular invasion, perithyroidal invasion, and tumor size were risk factors for ipsilateral paratracheal central LN metastasis; tumor size was an independent risk factor for pretracheal central LN metastasis, and pretracheal or/and ipsilateral paratracheal central LN metastasis were risk factors for contralateral paratracheal central LN metastasis. <b><i>Conclusion:</i></b> The extent of elective central LN dissection (CLND) should be decided based on different clinical pathological factors in cN&#8320; PTC patients. Moreover, elective prelaryngeal CLND may be unnecessary.