Key points are not available for this paper at this time.
Objective Accurate preoperative assessment of central lymph node metastasis (CLNM) in patients with unifocal papillary thyroid microcarcinoma (PTMC) remains challenging. This study aimed to develop and validate a nomogram integrating tumor spatial location with clinical and ultrasonographic features for predicting central lymph node metastasis (CLNM). Methods In this retrospective study, 432 patients with surgically confirmed unifocal PTMC were enrolled. Independent predictors were identified through univariate and multivariate regression, and a nomogram was constructed and internally validated. Results Age ≤38 years, tumor diameter 0.95 cm, microcalcifications, suspicious central/lateral lymph nodes, tumor in the isthmus, and tumor in the middle/inferior pole adjacent to the posterior capsule were independent risk factors for CLNM, while Hashimoto’s thyroiditis was protective. The nomogram showed good discrimination, with AUCs of 0.772 (training) and 0.728 (validation). Calibration and decision curve analysis confirmed clinical utility. Conclusion The spatial location-based nomogram provides an effective preoperative tool for quantifying CLNM risk, assisting in individualized surgical planning and reducing overtreatment in unifocal PTMC.
Pang et al. (Thu,) studied this question.