Does the size of unifocal papillary thyroid carcinomas affect the status of the cervical lymph nodes?

Papillary thyroid carcinoma (PTC) is the most common endocrine malignancy in humans. Cervical lymph node (LN) involvement is one of the major prognostic factors in disease recurrence and morbidity. Despite central lymph node dissection (CLND) is recommended in the case of involved LNs, prophylactic neck dissection is still controversial due to the potential complications associated with this procedure. The aim of the current review is to assess the correlation between the sizes of unifocal PTC with cervical LN involvement, which could help to choose the best treatment plan for patients with PTC. We performed a retrospective review for all patients who had unifocal PTC in our department from 2013 to 2019 with a minimum of 3 years of follow-up. SPSS software was used to calculate this correlation. Fifty-nine patients (38 females and 21 males) were included in our study with an average age of 45.4 ± 17 years of age. Out of 17 patients (28.8%) with microcarcinomas, six of them (10.2%) had cervical LN involvement, whereas of the 42 patients (71.2%) with macrocarcinomas, 17 of them (28.8%) had cervical LN metastasis. The correlation between the tumor size and the number of metastatic LNs in our study was weakly positive (r = 0.332, P < 0.05). The decision regarding CLND should be selected on an individual base as even small micro PTC could metastasize to the local LNs.