A Novel Scoring System for the Risk of Papillary Thyroid Cancer Metastases in Lymph Nodes Posterior to the Right of the Recurrent Laryngeal Nerve

ObjectiveSome surgeons believe that dissection posterior to the right recurrent laryngeal nerve lymph node (PRRLN-LN) is unnecessary for low metastasis rate and high complication risk. However, persistent metastatic nodes may have a higher recurrence rate, surgical risk, complications. Thus, it important distinguish patients who require PRRLN-LN dissection. To identify risk factors (LN-prRLN) establish scoring system help determine whether required in with papillary thyroid carcinoma.Methods821 participants were randomly allocated development validation cohorts 2:1 ratio. A nomogram-based predictive model LN-prRLN was established based on identified cohort.ResultsLN-prRLN diagnosed pathologically 124 of 821 (15.1%) from entire cohort. Multivariate analysis age (odds ratio [OR], 0.964; 95% CI, 0.945-0.983; P < .001), tumor size (OR, 1.536; 1.135-2.079; = .005), extrathyroidal extension (OR 2.271, 1.368-3.770; .002), clinically involved central compartment 1.643, 1.055-2.559; .028), lateral 4.271, 2.325-7.844; .001) as predictors LN-prRLN. well validated. Calibration curves evaluate nomogram both revealed concordance index 0.756 ± 0.058 0.745 0.042, respectively.ConclusionOur be useful helping decide which should undergo PRRLN-LN.