Accuracy of Intraoperative Determination of Central Node Metastasis by the Surgeon in Papillary Thyroid Carcinoma

Ji, Yong Bae; Lee, Dong Won; Song, Chang Myeon; Kim, Kyung Rae; Park, Chul Won; Tae, Kyung

doi:10.1177/0194599813519405

Cited by 36 publications

(18 citation statements)

References 23 publications

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“…The concept of therapeutic central neck dissection is well‐established in the treatment of papillary thyroid carcinoma (PTC) . However, the role of prophylactic central neck dissection and the extent of central neck dissection in surgery for PTC remain highly controversial . The support for prophylactic central neck dissection is based on the view that removal of microscopic metastases in the central compartment lymph node prevents recurrence and improves disease‐free and overall survival .…”

Section: Introductionmentioning

confidence: 99%

“…1 However, the role of prophylactic central neck dissection and the extent of central neck dissection in surgery for PTC remain highly controversial. 2 The support for prophylactic central neck dissection is based on the view that removal of microscopic metastases in the central compartment lymph node prevents recurrence and improves disease-free and overall survival. 3 Prophylactic central neck dissection is also recommended because of the high frequency of lymph node metastasis, 4 and the surgical difficulty and increased risk of complications when tumors recur in the central compartment.…”

Section: Introductionmentioning

confidence: 99%

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Frequency and pattern of central lymph node metastasis in papillary carcinoma of the thyroid isthmus

Song

Lee

et al. 2015

Head & Neck

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Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Frequency and pattern of central lymph node metastasis in papillary carcinoma of the thyroid isthmus

Song

Lee

et al. 2015

Head & Neck

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“…The most common method of surgical prophylaxis of postoperative HPT is the precision character of surgical manipulations with careful observation of the tacticaltechnical requirements to the surgeon: to identify TG in time, to mobilize precisely and maintain their blood supply [4,7]. At the same time, the small size of PTG and their vessels, the anatomical and embryological peculiarities of localization of these organs, consistency and color similarity with fatty tissue, lymph nodes, often make it impossible to keep them intact structurally and without ischemia.…”

Section: Problem Statement and Analysis Of The Recent Researchmentioning

confidence: 99%

Major Types of Parahtyroid Glands Location and Their Relationship with the Post-Operative Hypoparathyroidism

Pasko

2017

Arch. clin. med.

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We have performed 130 operations on the thyroid gland. The spectrum of surgical interventions on the thyroid gland was as follows: hemithyroidectomy was performed for 49.2% of patients, thyroidectomy -for 23.1% of patients and thyroidectomy with central and peripheral lymph node dissection -for 27.7% of patients. All patients were performed the determination of PTG type and their visual assessment. Types A and B1 are rarely traumatized during operations on thyroid gland, PTG of type B 2 and B 3 , C practically in almost all cases are damaged or become ischemic in a varying degree, therefore, types B 2 , B 3 and C can be considered as the risk factors for the development of postoperative HPT, and in case of type B 2 of PTG they were technically difficult to be isolated without damage, and in the B 3 and C types it is generally difficult to keep them intact. Determination of the type of PTG and their visual assessment is the basis for solution to the problem of preservation of PTG in place or of their autotransplantation.

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“…Cervical lymph node metastasis (LNM), extra-thyroidal extension (ETE), and distant metastasis are commonly regarded as the independent risk factors of PTC (9)(10)(11). The sensitivity and specificity in detecting cervical LNM by US are superior to those by palpation (12,13), although the value of diagnosis is moderate (36-72%) in clinical node-negative PTC (14). Recently, some authors reported that absence of thyroid capsule and contact with capsule on US were the independent risk factors for cervical LNM or ETE, but the related features were not evaluated in high-risk PTC patients (15)(16)(17).…”

Section: Introductionmentioning

confidence: 99%

Association Between Preoperative US, Elastography Features and Prognostic Factors of Papillary Thyroid Cancer With BRAFV600E Mutation

Chen

Dang

et al. 2020

Front. Endocrinol.

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Purpose: To investigate the value of US and elastography for predicting prognostic factors of papillary thyroid cancer (PTC) in the positive BRAF V600E Mutation group. Materials and Methods: A total of 116 BRAF V600E Mutation patients with PTCs were enrolled in this prospective study, who were preoperatively evaluated by US, US elasticity imaging (EI), and Virtual Touch tissue imaging (VTI) and Virtual Touch tissue quantification (VTQ) of acoustic radiation force impulse (ARFI) imaging. Multivariate logistic regression analysis was performed to assess 23 independent variables for predicting prognostic factors. Diagnostic performance was evaluated with receiver operating characteristic (ROC) curve analysis. Results: Forty-two (36.2%) of 116 PTC patients with BRAF V600E Mutation had central lymph node metastasis (LNM). Nine (7.8%) and fifty-six (48.3%) had lateral LNM and extra-thyroidal extension (ETE), respectively. In multivariate logistic regression analyses, rich internal flow [odds ratio [OR]: 6.66] was the best predictor for central LNM, followed by male sex (OR: 4.22), halo sign absence (OR: 2.78) (all P < 0.05). VTQ ratio (OR: 1.57) was the only predictor for lateral LNM (P = 0.02). Rich internal flow (OR: 6.33) was the strongest predictor for ETE, followed by male sex (OR: 3.29), halo sign absence (OR: 2.90), and VTQ ratio (OR: 1.63) (all P < 0.05). Conclusion: VTQ ratio on ARFI imaging, rich internal flow and halo sign absence on US are the predicting prognostic factors in PTC patients with BRAF V600E Mutation. The specificities were significantly increased by combining ARFI imaging and US features, which has a potential to avoid unnecessary therapeutic neck dissection in the high-risk PTC patients.

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Accuracy of Intraoperative Determination of Central Node Metastasis by the Surgeon in Papillary Thyroid Carcinoma

Abstract: Intraoperative determination of central lymph node metastasis by the surgeon is a limited guide for CND in clinically node-negative PTC because of its low sensitivity and specificity.

Cited by 36 publications

References 23 publications

Frequency and pattern of central lymph node metastasis in papillary carcinoma of the thyroid isthmus

Frequency and pattern of central lymph node metastasis in papillary carcinoma of the thyroid isthmus

Major Types of Parahtyroid Glands Location and Their Relationship with the Post-Operative Hypoparathyroidism

Association Between Preoperative US, Elastography Features and Prognostic Factors of Papillary Thyroid Cancer With BRAFV600E Mutation

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