Risk factors for lateral and skip lymph node metastasis in adolescents and young adults with papillary thyroid carcinoma

Background: Lateral lymph node metastasis (LLNM) and skip lymph node metastasis (SLNM) in papillary thyroid carcinoma (PTC) are generally unpredictable, especially in adolescents and young adults (AYAs). This study aims to investigate the risk factors associated with LLNM and skip SLNM in AYAs with PTC. Methods: This retrospective analysis was performed on the medical records of AYAs with PTC who underwent total or near-total thyroidectomy or lobectomy, along with central lymph node dissection (CLND) and lateral lymph node dissection (LLND) at The First Affiliated Hospital of Soochow University from January 2017 to December 2023. Variables identified as significant in the univariate analysis were further assessed using multivariate analysis. Continuous variables deemed significant were analyzed using receiver operating characteristic (ROC) curve analysis to establish optimal cut-off values. Logistic regression analysis was then employed to identify independent risk factors for LLNM and SLNM in AYAs with PTC. Results: Among the 545 AYAs with PTC, 480 individuals (88.1%) exhibited LLNM, with 54 of these 480 patients (11.3%) demonstrating SLNM. Univariate and multivariate analyses identified the diameter of the largest tumor [P