Abstract
Background
The aim of the present study was to examine the frequency, characteristics, and risk
factors of level IIb lymph node metastases in papillary thyroid carcinoma.
Methods
We reviewed and collected clinical and pathological records for 954 papillary thyroid
carcinoma patients with clinically positive lateral neck node metastasis. Univariate
and multivariate analyses were performed to detect risk factors for level IIb lymph
node metastasis; a predictive model was built based on multivariate analysis and tested
in a validation group.
Results
Level IIb lymph node metastasis was observed in 137 of 954 patients (14.4%). Univariate
and multivariate analyses using the training group indicated that gross extrathyroidal
extension of the primary tumor, tumor location in the upper pole, and preoperative
distant metastasis were 3 independent risk factors for level IIb lymph node metastasis.
This model was built and tested in a validation group, and the area under the curve
was 0.840 (P < .001). The cutoff of the IIb score was 12, which was tested in the validation group;
the sensitivity was 82.1% and the specificity was 95.6%.
Conclusion
Level IIb dissection should be performed in select patients with IIb scores ≥12.
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Article info
Publication history
Published online: March 13, 2020
Accepted:
February 4,
2020
Identification
Copyright
© 2020 Elsevier Inc. All rights reserved.
