Analysis of Risk Factors Associated With Central Lymph Node Metastasis in Papillary Thyroid Carcinoma With cT1N0 Stage

Abstract

AimAnnual T1 stage papillary thyroid carcinoma (PTC) incidence rates continue to rise, yet the optimal treatment for this cancer type remains controversial. Central lymph node metastasis (CLNM) is a critical determinant in the context of treatment decision-making. While several prior studies have evaluated patients with clinica l T1a(cT1a) stage PTC, there have been fewer analyses of clinical T1b(cT1b) disease to date. The present study was thus formulated to explore predictors of CLNM in patients with cT1a and cT1b stage PTC.MethodsA retrospective analysis of data including clinicopathological characteristics and BRAFV600E mutation status was conducted for 452 PTC patients undergoing surgical treatment. Logistic univariate and multivariate analyses were performed to identify risk factors associated with CLNM in particular patients’ characteristics and the accuracy of the established logistic regression models was evaluated using the R software platform.ResultsRespective CLNM incidence rates in cT1a and cT1b disease were 39.39% and 67.21%. Factors associated with a higher risk of CLNM among PTC(cT1a) patients included male sex, young age, tumor size, contact with capsule, and multifocality as determined through comparisons of the area under the curve for logistic regression models. Whereas male sex and age were associated with CLNM risk in PTC(cT1b) patients in univariate and multivariate analyses, age was the only risk factor associated with CLNM incidence among women with PTC(cT1b).ConclusionPredictors of CLNM differ between PTC patients with cT1a and cT1b stage disease, and a comprehensive assessment of these risk factors should thus be conducted when designing individualized treatment regimens for PTC patients.

Factors of Central Lymph Node Metastasis in Papillary Thyroid Cancer Based on C-TIRADS Analysis

“…Multifocal tumours are more malignant and aggressive; previous studies have found multifocality in PTC is also associated with CLNM [30]. Feng et al [31] the incidence of central lymph node metastasis was higher in patients with multifocal PTC than in those with isolated PTC.…”

“…Multifocality is an important biological characteristic of papillary thyroid carcinoma, with an incidence ranging from 18 % to 87 % [28,29]. Multifocal tumours are more malignant and aggressive; previous studies have found multifocality in PTC is also associated with CLNM [30]. Feng et al [31] the incidence of central lymph node metastasis was higher in patients with multifocal PTC than in those with isolated PTC.…”

“…The study included 1150 patients with postoperative, pathologically confirmed PTC, of whom 799 (69.5 %) were females, and 351 (30.5 %) were males. There were 30 The C-TIRADS score for PTC was 3.0 ± 1.0 and 2.8 ± 1.0 in the CLNM and non-CLNM groups, respectively, and the maximum diameter of the nodules was 17.1 ± 10.8 and 13.3 ± 9.2 in the CLNM and non-CLNM groups, respectively (both p-values < 0.001) (▶table 1).…”

“…The study included 1150 patients with postoperative, pathologically confirmed PTC, of whom 799 (69.5%) were females, and 351 (30.5%) were males. There were 30…”

Development and validation of clinical predictive models for differentiated thyroid carcinoma and cervical lymph node metastasis: A retrospective cohort study

“…However, in the established model, many studies only predict central lymph nodes, disregarding lymph node skip metastasis. [41][42][43] Tian's study is the closest to our study process; however, during this study, only the speci c ultrasound features were screened for predictors, and the validation of the population was divided into subgroups according to sex and age. This method of veri cation allows the model to have a signi cant discrimination in a speci c subgroup, however, it leads to relatively high risk of bias in the application of the model.…”