Abstract
The purpose of this study is to identify ultrasound predictive factors for both central and lateral lymph node metastases of thyroid carcinoma.
We performed a retrospective study collecting 120 data charts of patients managed for thyroid cancer in the ENT and Head and Neck surgery department of Fattouma Bourguiba university hospital of Monastir in Tunisia over five years (2016-2020). We included all data of patients who underwent total thyroidectomy with central lymph node dissection with or without lateral lymph node dissection. We analyzed ultrasound features of all nodules then we performed a statistical study to identify ultrasound predictive factors of lymph node metastasis.
The incidence of central and lateral lymph node metastasis of thyroid carcinoma was 45.8% and 35 %, respectively. Round-shaped nodules, strongly hypoechoic character, presence of microcalcifications, lymph nodes, and EU-TIRADS III and V scores were the ultrasound features significantly associated with lymph node metastases in the univariate analysis. In multivariate analysis, the presence of lymph nodes on ultrasound was the only predictor of metastasis in the central and lateral groups. However, calcifications, round-shaped nodule, and EU-TIRADS score III were exclusively predictive factors for central metastases.
We concluded that the presence of lymph nodes on ultrasound is the only predictive factor of lymph node metastases of thyroid carcinoma. Paradoxically, thyroid nodules with a low risk of malignancy (EU-TIRADS III) are predictive factors for central metastases.
KEYWORDS: differentiated thyroid carcinoma; ultrasonography; lymph node metastases; neck dissection; thyroidectomy
