Abstract:
Objective
To analyze the risk factors for ipsilateral central lymph node metastasis（CLNM） in patients with solitary papillary thyroid carcinoma （PTC） located in the lateral isthmus，and to construct a preoperative predictive model to guide surgical decision-making.
Methods
A total of 163 patients with solitary cN0 lateral isthmic PTC who underwent initial surgery between January 2016 and June 2022 were included.Univariate and multivariate Logistic regression analyses were performed to identify risk factors for ipsilateral CLNM.A nomogram prediction model was constructed and internally validated.
Results
The incidence of ipsilateral CLNM was 44.8% in the lateral isthmus PTC patients.Risk factors for ipsilateral CLNM included age ＜42 years，maximum tumor diameter ≥10 mm，aspect ratio ≥1，and extrathyroidal extension on ultrasound.The nomogram model for predicting ipsilateral CLNM in the lateral isthmus PTC patients showed an area under the receiver operating characteristic curve （AUC） of 0.814 （95% CI，0.748 to 0.880），with a mean AUC of 0.802 （95% CI，0.787 to 0.817） after 200 rounds of 10-fold cross-validation.
Conclusion
We identified risk factors for ipsilateral CLNM in PTC patients with tumors located in lateral parts of the isthmus and developed a nomogram prediction model.This model serves as an effective tool for preoperative assessment of CLNM，providing valuable guidance for surgeons in tailoring individualized surgical strategies.
Key words:
Papillary Thyroid Carcinoma,
Isthmus,
Central Lymph Node Metastasis,
Nomogram Prediction Model
Qiang Yuan, Huayu Zhang, Zhangzhe Yan, Hanfang Zhu, Guang Chen, Liang Sun, Yuan Lv, Gang Chen, Suo Zhao. Preoperative prediction model for central lymph node metastasis in cN0 lateral isthmic papillary thyroid carcinoma[J]. Chinese Journal of Operative Procedures of General Surgery(Electronic Edition), 2025, 19(03): 333-336.