We have analyzed our experience with differentiated thyroid cancer patients to investigate patterns of cervical lymph node metastasis and relationship with clinical parameters including sex, age, tumor size, histologic type, and extent of disease. The records of 105 patients treated surgically between 1989 and 1994 were reviewed. Female patients were 93 (88.6%) and mean age was 38 years(range: 1776 years). Papillary carcinoma occupied 72 cases(68.6%) and follicular type was 33 cases(31.4%). Total or near total thyroidectomy was carried out in 55 cases(52.4%), while unilateral lobectomy was done in 50 cases(47.6%). A total of 26 patients(24.8%) had cervical lymph node metastasis. Frequency of lymph node metastasis increased in female patients and older patients with age more than 40 years(33.3% versus 23.7% and 30.8% versus 2l.2% respectively). There was no difference in the frequency of lymph node metastasis with tumor size. Metastasis to cervical lymph node occurred in 30% of patients with small tumors less than 1 cm. There was no case with lymph node metastasis in follicular carcinoma, while all the metastasis occurred in papillary carcinoma. When we compared frequency of lymph node metastasis according to disease extent, patients with extrathyroidal extension of disease had cervical lymph node metastasis more frequently than those with disease confined to thyroid(60.9% versus 12.1%). In conclusion, cervical lymph node dissection at the time of thyroidectomy is mandatory to improve cure rate and to decrease the dose of radioactive iodine therapy after operation in differentiated thyroid carcinoma.
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