Effects of Patient and Tumor Characteristics on Central Lymph Node Metastasis in Papillary Thyroid Cancer: A Guide for Selective Node Dissection

Altıner, Saygın; Kozan, Ramazan; Emral, Ahmet Cihangir; Taneri, Ferit; Karamercan, Ahmet

doi:10.34172/aim.2022.115

Arch Iran Med

2022

DOI: 10.34172/aim.2022.115

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Effects of Patient and Tumor Characteristics on Central Lymph Node Metastasis in Papillary Thyroid Cancer: A Guide for Selective Node Dissection

Saygın Altıner

Ramazan Kozan

Ahmet Cihangir Emral

et al.

Abstract: Background: Prophylactic central lymph node dissection (CLND) in papillary thyroid carcinoma (PTC) is still controversial. This study aimed to analyze the factors related to the patient and tumor characteristics affecting central lymph node metastasis (CLNM) in PTC patients and to evaluate the contribution of the results to shaping the surgical treatment algorithm. Methods: Two hundred and fifty-five PTC patients who underwent total thyroidectomy and CLND were evaluated retrospectively. Histopathology reports … Show more

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Cited by 6 publications

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“…[ 2 , 3 ] Thyroid cancer patients are classified as good in terms of prognosis in long-term follow-ups. [ 4 ] and recurrence rates are very low. [ 5 ] In addition, developments in diagnostic methods increase the recognition of thyroid cancers today.…”

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confidence: 99%

Determination of Diagnostic Features of Serum Thyroid Hormones and Thyroglobulin Ratios in Normothyroid Differentiated Thyroid Carcinoma Cases

Aydogdu

2023

Sisli Etfal

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Objectives Ultrasonography and fine-needle aspiration biopsy (FNAB) are the gold standard methods in the prediction of benign and malignant thyroid nodules. However, despite being easily applicable, FNAB is an invasive procedure. Less invasive biomarkers should be utilized in the diagnosis of thyroid malignancies. In this study, we aimed to determine the parameters that can be used in the diagnosis of differentiated thyroid cancer (DTC) based on the serum thyroid and thyroglobulin (TG) levels which are routinely checked in patients followed up for thyroid nodules. Methods In the study, we evaluated patients who underwent thyroid surgery for nodular diseases between January 2015 and June 2022. Of the 1444 patients evaluated, 919 patients who met the inclusion criteria (normothyroid benign nodular disease or normothyroid DTC) were included in the study. Patients were divided into two groups as benign group (BG) and DTC group (DTCG). We compared patients’ pre-operative serum thyroid and TG values and the diagnostic properties of their ratios. Results Of the 919 patients included, 517 (56.3%) were in BG and 402 (43.7%) were in DTCG. In DTCG, 318 patients were female and 84 patients were male. The mean age in the DTCG was 47.8 years. Comparison of DTCG and BG revealed a significant difference between T3/T4 ratio (p=0.002), T3/TSH ratio (p≤0.001), T4/TSH ratio (p≤0.001), TG/TSH ratio (p≤0.001), and TSH/TG ratio (p≤0.001). However, evaluation of the specified values by ROC analysis showed that the T3/T4 ratio did not make a significant difference between the two groups (p=0.1), whereas the other values displayed a significant difference (p≤0.001 for T3/TSH, p=0.001 for T4/TSH, p≤0.001 for TG/TSH, and p<0.001 for TSH/TG). Conclusion T3/TSH (cutoff =2.183), T4/TSH (cutoff=0.6), and TG/TSH (cutoff=29.67) values were found to be significant tumor markers for the prediction of malignancy in thyroid nodules, and low values were found to be associated with malignancy. TSH/TG (cutoff=0.031) value was also significant in predicting malignancy while high values were found to be associated with malignancy. Thyroid hormone and TG ratios may alter the preferred treatment method for thyroid nodules.

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confidence: 99%

Determination of Diagnostic Features of Serum Thyroid Hormones and Thyroglobulin Ratios in Normothyroid Differentiated Thyroid Carcinoma Cases

Aydogdu

2023

Sisli Etfal

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Meta-analysis of prediction models for predicting lymph node metastasis in thyroid cancer

Liu,

Han,

et al. 2024

World J Surg Onc

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Background The purpose of this systematic review and meta-analysis is to assess the efficacy of various machine learning (ML) techniques in predicting preoperative lymph node metastasis (LNM) in patients diagnosed with papillary thyroid carcinoma (PTC). Although prior studies have investigated the potential of ML in this context, the current evidence is not sufficiently strong. Hence, we undertook a thorough analysis to ascertain the predictive accuracy of different ML models and their practical relevance in predicting preoperative LNM in PTC patients. Materials and methods In our search, we thoroughly examined PubMed, Cochrane Library, Embase, and Web of Science, encompassing their complete database history until December 3rd, 2022. To evaluate the potential bias in the machine learning models documented in the included studies, we employed the Prediction Model Risk of Bias Assessment Tool (PROBAST). Results A total of 107 studies, involving 136,245 patients, were included. Among them, 21,231 patients showed central LNM (CLNM) and 4,637 had lateral LNM (LLNM). The meta-analysis results revealed that the c-index for predicting LNM, CLNM, and LLNM were 0.762 (95% CI: 0.747–0.777), 0.762 (95% CI: 0.747–0.777), and 0.803 (95% CI: 0.773–0.834) in the training set, and 0.773 (95% CI: 0.754–0.791), 0.762 (95% CI: 0.747–0.777), and 0.829 (95% CI: 0.779–0.879) in the validation set, respectively. A total of 134 machine learning-based prediction models were included, covering 10 different types. Logistic Regression (LR) was the most commonly used model, accounting for 81.34% (109/134) of the included models. Conclusions Machine learning methods have shown a certain level of accuracy in predicting preoperative LNM in PTC patients, indicating their potential as a predictive tool. Their use in the clinical management of PTC holds great promise. Among the various ML models investigated, the performance of logistic regression-based nomograms was deemed satisfactory. Supplementary Information The online version contains supplementary material available at 10.1186/s12957-024-03566-4.

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Malignancy rates in thyroid nodules classified as benign according to the nodule size threshold of 4 cm

Aydoğdu,

Gülçek,

Büyükkasap

et al. 2024

Balıkesir Medical Journal

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SUMMARY Aim: The false negative rate of fine needle aspiration biopsy (FNAB) in large thyroid nodules ranges from 7.7% to 53%. The treatment of nodules that are 4 cm or larger is controversial because of the potential for false-negative FNAB results. In order to make treatment recommendations for nodules ≥4 cm in size, we compared the results of preoperative FNAB with thyroid surgery specimens. Materials and Methods: We evaluated patients who underwent thyroid surgery and had preoperative FNAB between 2017 and 2022. Patients were divided into two groups based on nodule size (

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Effects of Patient and Tumor Characteristics on Central Lymph Node Metastasis in Papillary Thyroid Cancer: A Guide for Selective Node Dissection

Cited by 6 publications

References 31 publications

Determination of Diagnostic Features of Serum Thyroid Hormones and Thyroglobulin Ratios in Normothyroid Differentiated Thyroid Carcinoma Cases

Determination of Diagnostic Features of Serum Thyroid Hormones and Thyroglobulin Ratios in Normothyroid Differentiated Thyroid Carcinoma Cases

Meta-analysis of prediction models for predicting lymph node metastasis in thyroid cancer

Malignancy rates in thyroid nodules classified as benign according to the nodule size threshold of 4 cm

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