Lymph node yield in the initial central neck dissection (CND) associated with the risk of recurrence in papillary thyroid cancer: A reoperative CND cohort study

Yu, Shitong; Ge, Jun-Na; Sun, Baihui; Wei, Zhigang; Xiao, Zizheng; Zhang, Zhicheng; Chen, Weisheng; Li, Tingting; Lei, Shangtong

doi:10.1016/j.oraloncology.2021.105567

Cited by 30 publications

(28 citation statements)

References 34 publications

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“…The appropriate cutoff values of the number of metastatic lymph nodes in predicting ER were 5 and 13 for the entire population and pathological N1b PTC patients, respectively. The prognostic value of lymph node yield in CND and LND in patients with PTC has been explored in previous studies (14)(15)(16). A higher lymph node yield in CND and LND is considered to be associated with lower disease recurrence rates.…”

Section: Discussionmentioning

confidence: 99%

Prognostic Factors for Excellent Response to Initial Therapy in Patients With Papillary Thyroid Cancer From a Prospective Multicenter Study

Dong

Zhang

et al. 2022

Front. Oncol.

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Prognostic factors for excellent response (ER) to initial therapy in patients with papillary thyroid cancer (PTC) have not been determined. In this study, we investigated the response to initial therapy in PTC patients and independent prognostic factors for ER in a prospective multicenter study in China. A total of 506 PTC patients from nine centers in China were enrolled in this study, all of whom underwent total or near total thyroidectomy with lymph node dissection and subsequent radioiodine therapy. Univariate and multivariable logistic regression analyses were carried out to determine the independent prognostic factors for ER. The optimal cutoff value of the number of metastatic lymph nodes for predicting ER was determined by the receiver operating characteristic curve. A total of 139 patients (27.5%) achieved ER after initial therapy. Extrathyroidal extension, the number of metastatic lymph nodes, and preablative-stimulated thyroglobulin (Ps-Tg) were independent risk factors for ER for the entire population. In a subgroup analysis, extrathyroidal extension and Ps-Tg were independent risk factors for ER in pathological N1a patients, while the number of metastatic lymph nodes and Ps-Tg were independent risk factors for ER in pathological N1b patients. The appropriate cutoff values of the number of metastatic lymph nodes in predicting ER were 5 and 13 for the entire population and pathological N1b PTC patients, respectively. PTC patients with more metastatic lymph nodes were more likely to fail to achieve ER. Extrathyroidal extension, the number of metastatic lymph nodes, and Ps-Tg were important prognostic factors for ER after initial therapy in PTC patients.

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Section: Discussionmentioning

confidence: 99%

Prognostic Factors for Excellent Response to Initial Therapy in Patients With Papillary Thyroid Cancer From a Prospective Multicenter Study

Dong

Zhang

et al. 2022

Front. Oncol.

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“…The LNY (unilateral) and positive LN number in all included patients are (expressed by median (IQR)) 1.0 (0, 3.0) and 0 (0, 1.0) respectively. It seems that LNY in this study is a smaller number compared with that in previous studies (20)(21)(22). We consider that there may be several reasons: the patients included in this study were planned to undergo thyroid lobectomy without the preoperative ultrasonography evidence of positive LN.…”

Section: Discussionmentioning

confidence: 89%

“…It is widely accepted that LN yield (LNY) can reflect the extent and quality of central neck dissection ( 20 , 21 ). The LNY (unilateral) and positive LN number in all included patients are (expressed by median (IQR)) 1.0 (0, 3.0) and 0 (0, 1.0) respectively.…”

Section: Discussionmentioning

confidence: 99%

Comparison of Supraclavicular Oblique Incision With Traditional Low Collar Incision Approach for Thyroidectomy in Differentiated Thyroid Cancer

Jiang

et al. 2022

Front. Oncol.

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BackgroundVarious incisions and approaches for thyroidectomy have been developed to treat differentiated thyroid cancer (DTC). Supraclavicular oblique incision (SOI) thyroidectomy (SOIT) has been applied in DTC patients over the past ten years. However, the safety and efficacy of this approach were yet to be confirmed.AimThis study aimed to compare the surgical and patient-related outcomes between SOIT and traditional low collar incision thyroidectomy (TLCIT) in patients with DTC.MethodsWe retrospectively screened all patients with DTC who received thyroid lobectomy from October 2020 to October 2021. The surgical results and patient-related outcomes assessed at 1 and 6 months after surgery by questionnaire were compared between the SOIT and TLCIT groups.ResultsA total of 128 patients were included in this study, of whom 38 patients (30.5%) were operated on with SOIT and 89 patients (69.5%) with TLCIT. There was no significant difference in demographic characteristics and thyroid features between the two groups. Despite comparable operative time (61.9 ± 12.1 vs. 59.9 ± 15.0 min, p = 0.425), the SOIT group had a smaller neck incision (4.4 ± 0.7 vs. 5.0 ± 1.0 cm, p = 0.002), a shorter duration of postoperative drainage (2.4 ± 0.5 vs. 2.7 ± 0.9 days, p = 0.019), less volume of postoperative drainage (48.4 ± 24.6 vs. 60.3 ± 22.8 ml, p = 0.040), and shorter postoperative hospitalization (3.2 ± 0.5 vs. 3.6 ± 0.9 days p = 0.006), as compared with the TLCIT group. At 1-month follow-up after surgery, SOIT showed better performance in preventing hypoparathyroidism (p = 0.026) and abnormal neck sensation (p = 0.010) and in improving cosmetic satisfaction (p = 0.036) than TLCIT. At 6-month follow-up, SOIT was feedback with better cosmetic satisfaction (p < 0.001) and a lower percent of abnormal neck sensation (p = 0.031) or movement (p = 0.005).ConclusionOur study suggests that minimally invasive surgery using the SOI provides superior surgical and patient-related outcomes compared with surgery using a traditional low collar incision (TLCI) in patients with DTC.

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“…In addition, research reports show that Lymph node yield (LNY) during initial central neck dissection (CND) surgery is an independent prognostic factor for recurrent/persistent disease in the central neck, LNY = 11 in bilateral CND procedures is an optimal number in estimating the prognosis of PTC patients undergoing total thyroidectomy plus bilateral CND. 20 The median number of central lymph node dissection (CND) and lymph node metastasis (LNY) in the lateral neck small incision approach group were 6 (2–7) and 0 (0–3), respectively. The median of central lymph node dissection (CND) and lymph node metastasis (LNY) in the traditional median approach group were 6 (2–7) and 0 (0–3), respectively.…”

Section: Discussionmentioning

confidence: 98%

Thyroidectomy Using the Lateral Cervical Small Incision Approach for Early Thyroid Cancer

Jin¹,

Zhang²,

Gao³

et al. 2022

CCID

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Objective Surgical resection is the main treatment for thyroid cancer, but while traditional open thyroidectomy improves prognosis, it also results in poor cosmetic outcomes. Therefore, we devised the lateral cervical small incision approach to thyroidectomy and will evaluate its efficacy. Methods The clinicopathological data of 191 patients who underwent unilateral thyroidectomy and isthmusectomy for early thyroid cancer were collected retrospectively. Of these, 100 patients underwent a traditional thyroidectomy using the median cervical approach (control group), and 91 patients underwent a thyroidectomy using the lateral cervical small incision approach (experimental group). The differences in perioperative prognosis, postoperative complications, and cosmetic outcomes between the two groups were evaluated. Results There was no significant difference in sex, age, tumor size, lymph node dissection, number of metastases, or postoperative complications between the experimental group and the control group (P > 0.05). There were significant differences in the duration of the operation; postoperative blood loss, drainage, and hospital stay; and scar color, blood circulation, hardness, and thickness between the groups (P < 0.05). The cosmetic outcomes of the incisions in the experimental group were more satisfactory than in the control group (P < 0.05). Conclusion When compared with traditional open thyroidectomy, the lateral cervical small incision approach has a lower incidence of complications, a better perioperative prognosis, and an improved cosmetic outcome.

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Lymph node yield in the initial central neck dissection (CND) associated with the risk of recurrence in papillary thyroid cancer: A reoperative CND cohort study

Cited by 30 publications

References 34 publications

Prognostic Factors for Excellent Response to Initial Therapy in Patients With Papillary Thyroid Cancer From a Prospective Multicenter Study

Prognostic Factors for Excellent Response to Initial Therapy in Patients With Papillary Thyroid Cancer From a Prospective Multicenter Study

Comparison of Supraclavicular Oblique Incision With Traditional Low Collar Incision Approach for Thyroidectomy in Differentiated Thyroid Cancer

Thyroidectomy Using the Lateral Cervical Small Incision Approach for Early Thyroid Cancer

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