Bilateral Papillary Thyroid Cancer Increases the Risk of Lymph Node Metastasis Compared with Unilateral Multifocal Papillary Thyroid Cancer

Han, Ja Ryung; Jung, Jin Hyang; Kim, Wan Wook; Lee, Jeeyeon; Park, Ho Yong; Kim, Hye Jung; Park, Jiyoung

doi:10.16956/jes.2017.17.2.63

Cited by 3 publications

(4 citation statements)

References 24 publications

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“…Results of our study show that bilaterality in multifocal PTC is associated with aggressive clinico-pathological markers such as older age, male gender, gross extrathyroidal extension, larger tumor size, locoregional and distant metastasis. Previous studies have also reported an association between multifocality and aggressive clinicopathological characteristics (23,24,(39)(40)(41).…”

Section: Discussionmentioning

confidence: 86%

Bilateral multifocality is an independent predictor of patients’ outcome in Middle Eastern papillary thyroid carcinoma

Parvathareddy

Siraj²,

Annaiyappanaidu³

et al. 2023

Front. Endocrinol.

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BackgroundTumor multifocality is frequently seen in Papillary thyroid carcinoma (PTC). However, few studies have analysed the impact of bilateral multifocality in PTC. The incidence of bilateral multifocality, its clinico-pathological associations and prognostic impact in PTC from Middle Eastern ethnicity remains unestablished.MethodsWe retrospectively evaluated 1283 patients who underwent total thyroidectomy for PTC. Bilateral and unilateral multifocality were decided based on the final pathology result. Primary outcome was recurrence free survival (RFS). Risk factors for bilateral multifocality were analyzed by multivariate logistic regression analysis.ResultsMultifocal PTC was found in 54.3% (697/1283) of patients. Among the 697 multifocal PTCs, 210 patients (30.1%) had unilateral multifocal PTC and 487 patients (69.9%) had bilateral multifocality. Bilateral multifocality was significantly associated with older age at diagnosis (p = 0.0263), male gender (p = 0.0201), gross extrathyroidal extension (p = 0.0332), larger primary tumor size (>4cm; p = 0.0002), lateral lymph node metastasis (p = 0.0008), distant metastasis at diagnosis (p = 0.0195) and recurrence (p = 0.0001). Bilateral multifocality was also found to be an independent predictor of RFS (Hazard ratio = 1.60; 95% Confidence Interval = 1.05 – 2.55; p = 0.0300). Multivariate logistic regression analysis demonstrated tumor diameter >4cm to be the only independent risk factors for bilaterality in multifocal PTC (Odds ratio = 1.86; 95% Confidence Interval = 1.13 – 3.07; p = 0.0155).ConclusionsIncidence of bilateral multifocality is high in Middle Eastern PTC. Tumor diameter >4cm can be considered as a predictive factor for bilateral multifocal PTC. Bilateral multifocality appears to be an important prognostic factor for PTC and an independent predictor of RFS. Therefore, patients with bilateral multifocal PTC may benefit from more frequent follow-up to identify recurrences earlier.

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Section: Discussionmentioning

confidence: 86%

Bilateral multifocality is an independent predictor of patients’ outcome in Middle Eastern papillary thyroid carcinoma

Parvathareddy

Siraj²,

Annaiyappanaidu³

et al. 2023

Front. Endocrinol.

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“…Out of 16 patients, Hashimoto's thyroiditis was detected in only one patient (6.3%), which is lower than expected. A study published in 2017 showed that Hashimoto's thyroiditis was found in (31.3%) [ 20 ]. In the Bethesda classification, patients classified with the 6th category (malignant) were very high (18 patients 81.8%).…”

Section: Discussionmentioning

confidence: 99%

“…Generally, most of the studies in PTC referred to multifocality without separation between unilateral and bilateral multifocality [ 27 , 28 ]. Only a few studies described the effect of unilateral and bilateral multifocality tumors on LNM [ 29 ]. In line with previous studies [ 12 , 28 ], we observed that bilaterality and multifocality were associated with aggressive features such as LNM.…”

Section: Discussionmentioning

confidence: 99%

“…However, there were results where evaluating the predictors of ≥5 LNM on bilateral solitary and bilateral multifocal (P = 0.014, P < 0.001) had a significant association. Additionally, it has been reported that predicting LNM is more correlated with bilaterality than multifocality [ 29 ]. Considering the tendency of PTC to be multifocal (often bilateral), some studies showed a low risk of recurrence after complete thyroidectomy compared with thyroid lobectomy [ 9 ].…”

Section: Discussionmentioning

confidence: 99%

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The impact of thyroid tumor features on lymph node metastasis in papillary thyroid carcinoma patients in head and neck department at KAMC: A retrospective cross-sectional study

Aljohani

Merdad

Alserif

et al. 2021

Annals of Medicine &Amp; Surgery

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Introduction Papillary thyroid carcinoma (PTC) is the most prevalent type of thyroid cancer. It is one of the most common types of malignancy of the thyroid that spreads to cervical lymph nodes. Lymph node metastasis (LNM) is an important factor when determining recurrence risk, and determining the extent of lymph node involvement can guide treatment. Our main objective is to evaluate the association between the size of the tumor and the number of lymph node metastases in patients with PTC. Methods: We conducted an electronic retrospective chart review of 125 patients with PTC followed in the Head and Neck Department at KAMC from 2009 to 2020. Twenty-two patients included in our study were pathologically and clinically diagnosed and confirmed to have LNM of PTC. Results: The study included 22 PTC patients who had undergone lymph node dissections. Patients had a median age of 38.8 years (IQR = 32.2–54.5), and the median tumor size was 20.5 mm. The most commonly affected level of the neck was IV (76.2%). Distant metastasis M1 was seen in only two patients (9.1%). Tumors sizes >30mm (75%) had ≥5 LNM. Most cases were the classic subtype PTC. For the site of the tumor, the site had a significant impact on the number of LNM (p = 0.004). Multifocality had a high impact on LNM (p = 0.019). Conclusions: This study showed no association between the size of PTC and the number of LNMs. The bilaterality of PTC was significantly associated with a high number of LNMs.

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Letter Regarding: “Prophylactic Central Neck Dissection Based on Preoperative Imaging and Intraoperative Surgeon’s Palpation versus Total Thyroidectomy Alone for Papillary Thyroid Cancer”

Sharma,

Kumar,

Singh

et al. 2024

Journal of Surgical Research

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Bilateral Papillary Thyroid Cancer Increases the Risk of Lymph Node Metastasis Compared with Unilateral Multifocal Papillary Thyroid Cancer

Cited by 3 publications

References 24 publications

Bilateral multifocality is an independent predictor of patients’ outcome in Middle Eastern papillary thyroid carcinoma

Bilateral multifocality is an independent predictor of patients’ outcome in Middle Eastern papillary thyroid carcinoma

The impact of thyroid tumor features on lymph node metastasis in papillary thyroid carcinoma patients in head and neck department at KAMC: A retrospective cross-sectional study

Letter Regarding: “Prophylactic Central Neck Dissection Based on Preoperative Imaging and Intraoperative Surgeon’s Palpation versus Total Thyroidectomy Alone for Papillary Thyroid Cancer”

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