Multifocality and Total Tumor Diameter Predict Central Neck Lymph Node Metastases in Papillary Thyroid Microcarcinoma

Zhao, Qi; Ming, Jie; Liu, Chunping; Shi, Liping; Xu, Xia; Nie, Xiu; Huang, Tao

doi:10.1245/s10434-012-2654-2

Cited by 145 publications

(124 citation statements)

References 36 publications

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“…Therefore, the TTD, which was defined as the sum of the maximal diameter of each lesion, was calculated. Univariate and multivariate analyses revealed that TTD >10 mm was statistically significantly associated with CLNM in the present study, which was similar to the findings of a previous study by Zhao et al (31). In the present study, tumor bilaterality was not an independent predictive factor for CLNM, although this has been demonstrated to be significantly associated with CLNM in a previous study (24).…”

Section: Discussionsupporting

confidence: 91%

Prediction of central lymph node metastasis in 392 patients with cervical lymph node-negative papillary thyroid carcinoma in Eastern China

et al. 2015

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Abstract. Central lymph node metastasis (CLNM) is common in papillary thyroid microcarcinoma (PTMC). The aim of the present study was to investigate the risk factors associated with CLNM in clinical lateral cervical lymph node-negative (cN0) PTMC in Eastern China. A total of 392 patients with confirmed PTMC by histological examination who underwent thyroidectomy and central neck lymph node dissection (CND) between May 2011 and October 2012 at the First Affiliated Hospital of Wenzhou Medical University (Wenzhou, China) were enrolled. The clinicopathological and ultrasonographic data from the patients were analyzed retrospectively. A scoring system was developed on the basis of independent predictive factors for CLNM. Male gender, age <45 years, maximum tumor diameter >5 mm, lower lobe location, multifocal carcinoma with total tumor diameter >10 mm and extracapsular spread were independent predictive factors for CLNM according to logistic regression analysis. The clinicopathological score was statistically significant, with an index point ≥2 indicating CLNM with 86.2% sensitivity and 70.4% specificity. The findings of the present study indicate that CND may be recommended to be routinely performed when the clinicopathological index point ≥2.

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Section: Discussionsupporting

confidence: 91%

Prediction of central lymph node metastasis in 392 patients with cervical lymph node-negative papillary thyroid carcinoma in Eastern China

et al. 2015

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“…Although these differences were too small to be significant, they suggest that multifocality might represent the tumor burden and predict more aggressive behavior during disease progression. An interesting finding of the current study was that an increasing number of tumor foci was associated with a younger age at diagnosis in PTC, in contrast to previous reports that advanced age is a prognostic factor for poor prognosis in PTC [12][13][14][15]. Younger age may indicate greater risk for the evolution of biological aggressiveness, such as multifocality; we previously reported that younger age is significantly associated with cervical LNM in PTC.…”

Section: Discussioncontrasting

confidence: 83%

Predictive Factors for Occult Contralateral Papillary Thyroid Carcinoma in Patients with Ipsilateral Multifocality on Frozen Biopsy

Park¹,

Lee²,

Lee³

et al. 2017

Korean J Otorhinolaryngol-Head Neck Surg

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Background: Papillary thyroid cancer (PTC) often presents as multifocal. However, the association of multifocality with poor prognosis remains controversial. The aim of this retrospective study was to identify the characteristics of PTC with multiple foci and to evaluate the association between multifocality and prognosis. Methods: We reviewed the medical records of 496 patients who underwent total thyroidectomy for PTC. Patients were classified as G1 (1 tumor focus), G2 (2 foci), and G3 (3 or more foci). We analyzed the clinicopathological features and clinical outcomes in each classification. A Cox regression model was used to assess the relationship between multifocality and recurrence or cancer mortality. Results: The G1, G2 and G3 groups included 287, 141 and 68 patients, respectively. The mean age was 47.1 ± 16.1 yr in G1, 41.1 ± 18.4 yr in G2, and 35.5 ± 15.9 yr in G3 and differed significantly among the 3 groups (p = 0.001). The proportion of extrathyroidal extension, central lymph node metastasis (CLNM), and lateral lymph node metastasis (LLNM) in the G1 to G3 groups increased with increasing number of tumor foci. The Kaplan-Meier curves revealed that G3 had the shortest recurrence-free survival, and differences were significant among the 3 groups (p = 0.001, Log Rank test). Furthermore, cancer-specific survival rates decreased significantly with increasing number of tumor foci (p = 0.041). Independent predictors of recurrence by multivariate Cox analysis included >3 tumor foci [HR 2.60, 95% confidence interval (CI) 1.53-4.39, p = 0.001] and extrathyroidal extension (HR 1.95, CI 1.12-3.38, p = 0.018). Conclusion: An increase in the number of tumors is associated with a tendency toward more aggressive features and predicts poor prognosis in PTC.

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“…Studies have shown multifocal PTC may be related to clonal selection from a preneoplastic field and spread throughout the thyroid gland (Jovanovic et al, 2010;Mazeh et al, 2011), which may be linked to central compartment LNM (Zhao et al, 2013). Kim et al (2013) also demonstrated that multifocaltiy is an independent predictive factor for central LNM.…”

Section: Discussionmentioning

confidence: 99%

Risk Factors for Nodal Metastasis in cN0 Papillary Thyroid Microcarcinoma

Zhang¹,

Liu²,

Liu³

et al. 2015

Asian Pacific Journal of Cancer Prevention

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Multifocality and Total Tumor Diameter Predict Central Neck Lymph Node Metastases in Papillary Thyroid Microcarcinoma

Abstract: Multifocal PTMC with TTD > 1 cm has a similar risk of LNM as a clinical papillary cancer. Routine central neck dissection is recommended in this subgroup of patients.

Cited by 145 publications

References 36 publications

Prediction of central lymph node metastasis in 392 patients with cervical lymph node-negative papillary thyroid carcinoma in Eastern China

Prediction of central lymph node metastasis in 392 patients with cervical lymph node-negative papillary thyroid carcinoma in Eastern China

Predictive Factors for Occult Contralateral Papillary Thyroid Carcinoma in Patients with Ipsilateral Multifocality on Frozen Biopsy

Risk Factors for Nodal Metastasis in cN0 Papillary Thyroid Microcarcinoma

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