Relationship between focality and cervical lymph nodes metastasis in papillary thyroid carcinoma


  • Tarek M. Rageh Department of General Surgery, Menoufia University, Menoufia, Egypt
  • Rehab M. Samaka Department of Pathology, Menoufia University, Menoufia, Egypt
  • Mahmoud G. Hagag Department of General Surgery, Menoufia University, Menoufia, Egypt
  • Elsayed A. Motawa Department of Surgical Oncology, Tanta Cancer Center, El Gharbia Governorate, Egypt



Cervical lymph node metastasis, Focality, Papillary thyroid carcinoma, Recurrence


Background: Papillary Thyroid Cancer (PTC) is the most common malignancy in thyroid gland and may be unifocal or multifocal. This study compares between unifocal and multifocal PTC to clarify which type has an aggressive behaviour.

Methods: This retrospective and prospective cross-sectional study was done on one hundred PTC patients who underwent papillary thyroid cancer management. The unifocal and multifocal groups each one contains 50 patients. The study was done in the period between January 2015 to January 2018. Other types of cancer thyroid and distant metastatic thyroid cancer were excluded from the study. All patients underwent follow up for one year.

Results: There are significant differences between unifocal and multifocal PTC regarding to age, the number of positive lymph nodes, history of multinodular goiter (MNG) and capsular invasion. The capsular invasion in multifocal increase the recurrence rate (P=0.03).

Conclusions: The new proposed method for PTC tumor size assessment could be a valuable in multifocal PTC patient’s stratification into low risk and high-risk subgroups. Therefore, high risk multifocal PTC patients could have a poor prognosis and high rate of recurrence, for that require aggressive treatment and strict follow up.


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