Objective:

To investigate the influence of posterior minimal extrathyroidal extension (post-mETE) and anterior minimal extrathyroidal extension (ant-mETE) on lateral lymph node metastasis (LLNM) in papillary thyroid carcinoma (PTC) patients and to develop a nomogram for perioperative management.

Approach:

Key Findings:

• 21.75% of patients had pathologically confirmed LLNM.
• Post-mETE was significantly associated with a higher incidence of LLNM compared to ant-mETE (p<0.001).
• Identified 6 independent predictive factors for LLNM: maximum tumor diameter >1 cm (OR = 3.022), bilateral thyroid involvement (OR = 2.198), multifocality (OR = 1.374), number of central lymph node metastases ≥2 (OR = 8.083), tumor located at the upper pole (OR = 2.679), and post-mETE (OR = 2.036).
• The nomogram demonstrated good discrimination performance (AUC = 0.850).

Interpretation:

Limitations:

• Retrospective design may introduce selection bias.
• Findings are based on a single institution's data.

Conclusion:

Attribution Notice

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