Cervical lymph node metastases are associated with compromised survival in young patients with papillary thyroid cancer, a new study published online ahead of print in the Journal of Clinical Oncology has shown.

Cervical lymph node metastases are known to be associated with poorer survival in patients aged 45 years or older with papillary thyroid cancer, but researchers sought to determine whether patients younger than 45 years also have reduced survival.

For the study, researchers identified 47,902 adults patients younger than 45 years undergoing surgery for stage I papillary thyroid cancer from the National Cancer Data Base (NCDB) and 21,855 from the SEER database.

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Results showed that overall survival was worse for patients with nodal metastases versus those that did not have them (NCDB: HR=1.32; 95% CI: 104, 1.67; P=0.021; SEER: HR=1.29; 95% CI: 1.08, 1.56; P=0.006).

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Researchers found that increasing number of metastatic lymph nodes up to six was associated with decreasing overall survival (HR=1.12; 95% CI: 1.01, 1.25; P=0.03).

The findings suggest that the American Joint Committee on Cancer staging for papillary thyroid cancer should be revised to include cervical lymph node metastases in patients under 45 years of age. In addition, patients rigorous preoperative screening for nodal metastases should be performed as six or fewer metastatic lymph nodes negatively impact survival.


  1. Adam MA, Pura J, Goffredo P, et al. Presence and number of lymph node metastases are associated with compromised survival for patients younger than age 45 years with papillary thyroid cancer. J Clin Oncol. 2015. [Epub ahead of print]. doi: 10.1200/JCO.2014.59.8391.