Adequate lymph node yield (ALNY) in papillary thyroid cancer represents the number of lymph nodes examined per T stage to rule out occult nodal disease with 90% confidence. Specifically, ALNY has six nodes for stage T1b, nine for T2, and 18 for T3. Rachel E. Conley, BA, and colleagues aimed to identify factors related to ALNY in patients with papillary thyroid cancer who underwent thyroidectomy and had at least one lymph node assessed.

The analysis included 4,528 patients. Only 34% of the total cohort had ALNY. Conley and colleagues found that ALNY declined with more advanced stages of disease (T1b: 38%; T2: 33.6%; T3: 28.6%; P<0.001). Patients with ALNY had longer operation times (P<0.001) and hospital stays (P<0.001) versus patients without ALNY. People with ALNY were more likely to experience recurrent laryngeal nerve injury or dysfunction themselves(P< 0.001). Postoperative hypocalcemia within 30 days was seen in 33.1% of patients with ALNY compared with 7.5% without ALNY (P<0.001). The proportion of patients with ALNY increased from 30% to 36.4% from 2016 to 2020, Conley and colleagues found.

The findings are consistent with previous studies, the researchers noted.

“The current study also suggests that ALNY is associated with longer operations, longer hospitalization, and higher risk for recurrent laryngeal nerve injury and hypocalcemia. These results can inform surgeons about adequate lymph node dissection’s benefits and potential complications.”