Differences in the characteristics of papillary thyroid microcarcinoma ≤5 mm and &gt;5 mm in diameter

Kim, Eun Young; Choi, June Young; Koo, Do Hoon; Lee, Kyu Eun; Youn, Yeo-Kyu

doi:10.1002/hed.23654

Cited by 16 publications

(12 citation statements)

References 19 publications

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“…In our present study, the thyroid lobe was divided into three parts referred to the isthmus of the gland, but our results showed that there was no significant correlation between CCLN metastasis and the tumor location. It is confirmed that tumor size, capsule involvement or extraglandular invasion, and multifocal tumors are risk factors of CCLN metastasis (39)(40)(41)(42)(43)(44)(45)(46)(47)(48). Consistent with our present results, capsule involvement and tumor size were independent risk factors according to the multivariate regression analysis.…”

Section: Ito Et Al Investigated the Clinical Significance Of Lymph Nodessupporting

confidence: 90%

Risk Factors of Central Lymph Node Metastasis in Papillary Thyroid Microcarcinoma and the Value of Sentinel Lymph Node Biopsy

Zhao

Yan

et al. 2021

Front. Surg.

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Objective: The present study aims to investigate the risk factors of central lymph node metastasis (CNM) in papillary thyroid microcarcinoma (PTMC) and evaluate the predictive value of sentinel lymph node biopsy (SLNB) during surgery.Methods: The clinicopathological data of 179 patients with PTMC staging in cN0 and with SLNB performed were analyzed retrospectively. Positive sentinel lymph node ratio (PSLNR) and additional positive lymph node (APLN) were analyzed in cases with positive SLNB. The efficiency of SLNB was investigated. ROC curves were plotted to evaluate the predictive value of PSLNR for APLN.Results: Cumulative maximum diameter of tumors (CMD) (P = 0.041) and capsule involvement (CI) (P = 0.014) were independent risk factors for central lymph node metastasis. The SLNB success rate was 97.28%, and the incidence of CNM was 31.28%. The sensitivity, specificity, false positive rate (FPR), false negative rate (FNR), positive predictive value (PPV), and negative predictive value (NPV) of SLNB to evaluate CNM and APLN were 82.14 vs. 61.54%, 100 vs. 80.39%, 0 vs. 19.61%, 17.86 vs. 38.46%, 100 vs. 34.78%, and 92.48 vs. 92.48%, respectively. For cases with positive SLNB, subgroup analysis was performed according to APLN. The PSLNRs of true and false positive groups were 0.4620 ± 0.1744 and 0.2425 ± 0.1355, respectively (P < 0.001). Analyzing the predictive value of PSLNR by the ROC curve, the optimal diagnostic cutoff point was 0.2917 [AUC = 0.861 (95% CI: 0.757, 0.966), P < 0.001], and the sensitivity, specificity, FPR, FNR, PPV, and NPV of PSLNR were 87.50, 73.33, 26.67, 12.50, 63.64, and 91.67%, respectively.Conclusion: CMD and CI are independent risk factors for central lymph node metastasis in PTMC. SLNB has good predictive value for CNM. For cases with positive SLNB, PSLNR could be used to predict the presence of APLN, which may provide a theoretical basis for intraoperative lymph node dissection.

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Section: Ito Et Al Investigated the Clinical Significance Of Lymph Nodessupporting

confidence: 90%

Risk Factors of Central Lymph Node Metastasis in Papillary Thyroid Microcarcinoma and the Value of Sentinel Lymph Node Biopsy

Zhao

Yan

et al. 2021

Front. Surg.

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“…Tumor size is considered to be an essential prognostic factor in patients with PTMC 19 . Although the majority of previous studies used a tumor size of 5 mm as the size threshold 20-23 , we assessed thresholds greater than 4 mm, 5 mm, 6 mm, 7 mm, and 8 mm by ROC curve analysis, and found that primary tumor size (> 6 mm) was significantly correlated with CLNM.…”

Section: Discussionmentioning

confidence: 99%

Risk factors for cervical lymph node metastasis in papillary thyroid microcarcinoma: a study of 1,587 patients

Zheng

Chen

Gao

et al. 2019

Cancer Biology & Medicine

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Objective: The purposes of this study were to identify risk factors for cervical lymph node metastasis and to examine the association between BRAF V600E status and clinical features in papillary thyroid microcarcinoma (PTMC). Methods: A total of 1,587 patients with PTMC, treated in Tianjin Medical University Cancer Institute and Hospital from January 2011 to March 2013, underwent retrospective analysis. We reviewed and analyzed factors including clinical results, pathology records, ultrasound results, and BRAF V600E status. Results: Multivariate logistic regression analyses demonstrated that gender (male) [odds ratio (OR) = 1.845, P = 0.000], age (< 45 years)(OR = 1.606, P = 0.000), tumor size (> 6 mm) (OR = 2.137, P = 0.000), bilateralism (OR = 2.011, P = 0.000) and extrathyroidal extension (OR = 1.555, P = 0.001) served as independent predictors of central lymph node metastasis (CLNM). Moreover, CLNM (OR = 29.354, P = 0.000) served as an independent predictor of lateral lymph node metastasis (LLNM). Among patients with a solitary primary tumor, those with tumor location in the lower third of the thyroid lobe or the isthmus were more likely to experience CLNM (P < 0.05). Univariate analyses indicated that CLNM, LLNM, extrathyroidal extension, and multifocality were not significantly associated with BRAF V600E mutation. Conclusions: The present study suggested that prophylactic neck dissection of the central compartment should be considered in patients with PTMC, particularly in men with tumor size greater than 6 mm, age less than 45 years, extrathyroidal extension, and tumor bilaterality. Among patients with PTMC, BRAF V600E mutation is not significantly associated with prognostic factors. For a better understanding of surgical management of PTMC and the risk factors, we recommend multicenter research and long-term follow-up.

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“…PTMC with size >0.5 cm may be associated with more vascular and extrathyroid invasion, more incidence in females and more CLNM (38). Lee et al (39) demonstrated that PTMC CLNM of tumor size ≤0.5 cm compared with size >0.5 cm was 18.2 vs. 29.2% (P=0.018), and LLNM was only 5.5% (39).…”

Section: Discussionmentioning

confidence: 99%

“…Multiple microcalcifications were recognized as an important feature of malignancy, and PTMC with calcification was detected with a large size and higher lymph node ratio compared with non-calcified lesions (45). Unfortunately, these options remain controversial (34,38). The present univariate analysis result revealed that multifocality was a significant high-risk factor for LLNM, however, in the multivariate analysis, they were not significant.…”

Section: Discussionmentioning

confidence: 99%

Clinicopathological features for predicting central and lateral lymph node metastasis in papillary thyroid microcarcinoma: Analysis of 66 cases that underwent central and lateral lymph node dissection

Tao

Wang

et al. 2016

Molecular and Clinical Oncology

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Currently the surgical approach for papillary thyroid microcarcinoma (PTMC), particularly the range of lymph node dissection, remains controversial. The present study aims to evaluate the risk factors for central and lateral lymph node metastasis (CLNM and LLNM) for appropriate clinical decision of neck lymph node dissection in PTMC. A total of 66 cases of PTMC that underwent unilateral or bilateral lobectomy plus prophylactic cervical lymph node dissection were collected for clinicopathological evaluation, including age, gender, tumor size, subtypes, extrathyroidal invasion, multifocality, calcifications, loss of cellular polarity/cohesiveness (LOP/C) in the invasive front, CLNM and LLNM, and retrospectively analysis. Univariate analysis revealed that LOP/C was significantly associated with CLNM (P=0.001) and LLNM (P<0.0001). The male gender was a risk factor of CLNM (P=0.04), while the age <45 years, tumor size >0.5 cm and multifocality were high-risk factors of LLNM (P=0.022, 0.044 and 0.005, respectively). Multivariable analysis revealed that LOP/C was significantly associated with CLNM [P=0.007, odds ratio (OR)=7.765, 95% confidence interval (CI)=1.773–33.996] and LLNM [P=0.029, OR=5.717, 95% CI=1.190–27.470]. Both multivariable analysis and χ2 test revealed that CLNM was another important high-risk factor of LLNM (P=0.021, OR=5.444, 95% CI=1.290–22.969, χ2=17.867, P<0.001). The present study revealed that prophylactic central lymph node dissection is essential for PTMC surgery and that prophylactic lateral lymph node dissection is recommend for patients with LOP/C and CLNM, which can be performed by intraoperative frozen section pathological examination. This must be considered discreetly in the case of patients with age <45 years, tumor size >0.5 cm and multifocal lesions.

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Differences in the characteristics of papillary thyroid microcarcinoma ≤5 mm and >5 mm in diameter

Abstract: The clinicopathologic features of PTMCs ≤5 mm and >5 mm are similar, except for sex distribution and extrathyroidal extension. The 5-year recurrence rate in the 2 groups did not differ significantly.

Cited by 16 publications

References 19 publications

Risk Factors of Central Lymph Node Metastasis in Papillary Thyroid Microcarcinoma and the Value of Sentinel Lymph Node Biopsy

Risk Factors of Central Lymph Node Metastasis in Papillary Thyroid Microcarcinoma and the Value of Sentinel Lymph Node Biopsy

Risk factors for cervical lymph node metastasis in papillary thyroid microcarcinoma: a study of 1,587 patients

Clinicopathological features for predicting central and lateral lymph node metastasis in papillary thyroid microcarcinoma: Analysis of 66 cases that underwent central and lateral lymph node dissection

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