Lateral neck recurrence from papillary thyroid carcinoma: Predictive factors and prognostic significance

Giordano, Davide; Frasoldati, Andrea; Kasperbauer, Jan L.; Gabrielli, Enrico; Pernice, Carmine; Zini, Michele; Pedroni, Corrado; Cavuto, Silvio; Barbieri, Verter

doi:10.1002/lary.25094

Cited by 29 publications

(18 citation statements)

References 22 publications

(59 reference statements)

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“…Lateral LNs metastases are considered as a more advanced stage of PTC, with a relatively high incidence of recurrence and early postoperative morbidity . Although the LND incision length was decreased, a neck scar is still unavoidable after conventional surgery, which is of great concern to young women and people with particular occupations for patients who insist that cosmetic appearance is of great importance.…”

Section: Discussionmentioning

confidence: 99%

Feasibility and safety of needle‐assisted endoscopic thyroidectomy with lateral neck dissection for papillary thyroid carcinoma: a preliminary experience

et al. 2019

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Background: Endoscopic thyroidectomy is popular among patients with cosmetic requirements. However, when lateral neck dissection (LND) is required, endoscopic surgery may be challenging. Therefore, we introduced needle-assisted endoscopic technique to achieve endoscopic LND procedure and evaluated its safety and feasibility in the present study. Methods: Medical records of 37 patients who underwent needle-assisted endoscopic thyroidectomy with LND were retrospectively reviewed. Results: All of 37 patients had excellent cosmetic outcomes. The mean operative time was 338.2 ± 58.74 minutes. Mean number of lymph nodes retrieved in the lateral was 33.5 ± 11.69 and 15.9 ± 7.51 in the central neck. The rates of transient and permanent hypocalcemia were 32.4% and 2.7% and the rates of transient and permanent recurrent laryngeal nerve palsy were 8.1% and 0%, respectively. Conclusions: Needle-assisted endoscopic thyroidectomy with lateral neck dissection shows potential feasibility but further study is needed to better characterize its safety and applicability. K E Y W O R D Spapillary thyroid carcinoma, endoscopic thyroidectomy, lateral neck dissection, needle assisted, anterior chest approach

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Section: Discussionmentioning

confidence: 99%

Feasibility and safety of needle‐assisted endoscopic thyroidectomy with lateral neck dissection for papillary thyroid carcinoma: a preliminary experience

et al. 2019

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“…However, the clinical behaviors of this cancer are complex and varied. Cervical lymph node metastasis (LNM) is frequently observed in PTC patients with an average incidence of 60% 1 because PTC tends to spread via lymphatic ducts 2 . According to some studies, PTC LNM are reported to have no significantly clinical effects on the outcomes in low-risk patients, however, a study with large samples (9904 patients) found that PTC with LNM, age >45 years, distant metastasis, and large tumor size could significantly predict poor overall survival outcome 3 .…”

Section: Introductionmentioning

confidence: 99%

Values of ultrasound features and MMP-9 of papillary thyroid carcinoma in predicting cervical lymph node metastases

Zhang

Luo

Zhang

et al. 2017

Sci Rep

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Preoperative assessment of the cervical lymph node status is important in therapeutic schedule and further evaluations of prognosis for papillary thyroid carcinoma (PTC) patients. Our aim was to investigate the diagnostic values of conventional ultrasound (US), contrast-enhanced ultrasound (CEUS) features and the expression of MMP-9 of PTC in predicting the cervical lymph node metastases (LNM). In total, 156 patients with PTC confirmed by surgical pathology were included. Seventy-one patients had cervical LNM, while 85 patients had no LNM. The patients had cervical LNM (39.51 ± 13.29 years) were younger than those had no LNM (44.15 ± 10.94 years) (P = 0.02). Multivariate logistic regression results showed that tumor size ≥0.95 cm (OR = 13.47), ill-defined margin (OR = 4.31), internal heterogeneous low-enhancement (OR = 5.19) and ECE (OR = 25.25) were predictive for the presence of cervical LNM. The detection rate of ECE for the PTC with LNM by CEUS (81.48%, 44/54) was higher than by US (46.30%, 25/54). There was significant difference in MMP-9 intensity between PTC with and without cervical LNM (P = 0.000), and intense reactions (+++) were mainly found in the PTCs with LNM (80.95%, 17/21). In conclusion, the combination of conventional US, CEUS features and MMP-9 expression may serve as an effective tool for predicting the cervical LNM of PTC.

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“…However, the clinical behaviors of this cancer are complex and varied. PTC is easy to spread via lymphatic ducts, which results in recurrence, metastases, and even death [ 1 ]. Recurrent PTC mainly refers to localized and distant recurrence, including recurrence of the primary tumor, lymph node metastases, invasion of the esophagus and trachea, invasion of muscles, soft tissues and nerves, and distant metastases.…”

Section: Introductionmentioning

confidence: 99%

Clinicopathological features of recurrent papillary thyroid cancer

et al. 2015

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BackgroundTo investigate the clinicopathological features of recurrent papillary thyroid carcinoma (PTC).MethodsA retrospective analysis on clinical and pathological data of 34 patients with recurrent PTC was carried out. A total of 281 patients with non-recurrent PTC during the same time period were chosen as the control group.ResultsPatients were divided into three groups according to the pathological subtype. The number of patients belonging to Groups 1, 2, and 3 were 28, 154, and 133, respectively. 78 patients underwent partial or whole thyroidectomy, 151 cases underwent thyroidectomy combining neck regional lymph node dissection, and 86 patients underwent thyroidectomy combining modified or radical neck dissection. Univariate analysis showed that PTC recurrence was associated with tumor size, extrathyroid invasion, initial surgery approach, lymph node metastasis, and pathological subtype (P < 0.05). Patient age, gender, complication with Hashimoto's thyroiditis, and multifocality were unrelated to PTC recurrence (P > 0.05). Multivariate analysis showed that initial surgery approach and pathological subtype perform important functions in PTC recurrence (P < 0.001). Initial surgery approach presented a negative correlation with PTC recurrence (β = −0.320, OR = 0.726). The pathological subtype was also related to PTC recurrence (β = 0.923, OR = 2.517).ConclusionPTC patients without neck dissection showed greater likelihood of postoperative recurrence. Patients with the tall cell, columnar cell, diffuse sclerosing, and oncocytic variants showed a higher propensity for PTC recurrence after operation compared with those who did not. Tumor volume, extrathyroid invasion, and multiple lymph node metastases at the time of initial operation were also significantly related to postoperative recurrence. Follow-up supervision must be enhanced after initial treatment to mitigate PTC recurrence in susceptible patients. Effective and standard treatments must be adopted immediately after the discovery of recurrence.

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Lateral neck recurrence from papillary thyroid carcinoma: Predictive factors and prognostic significance

Abstract: 4.

Cited by 29 publications

References 22 publications

Feasibility and safety of needle‐assisted endoscopic thyroidectomy with lateral neck dissection for papillary thyroid carcinoma: a preliminary experience

Feasibility and safety of needle‐assisted endoscopic thyroidectomy with lateral neck dissection for papillary thyroid carcinoma: a preliminary experience

Values of ultrasound features and MMP-9 of papillary thyroid carcinoma in predicting cervical lymph node metastases

Clinicopathological features of recurrent papillary thyroid cancer

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