Predictive Factors for Lymph Node Metastasis in Papillary Thyroid Microcarcinoma

Kim, Seo Ki; Park, Inhye; Woo, Jung-Woo; Lee, Jun Ho; Choe, Jun-Ho; Kim, Jung-Han; Kim, Jee Soo

doi:10.1245/s10434-016-5225-0

Cited by 94 publications

(101 citation statements)

References 40 publications

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“…Although PTMC is believed to be an indolent disease, the reported incidence of central lymph node metastasis (CLNM) associated with PTMC has been reported to be as high as 41.3% [8], and CLNM is known to be related to poor prognosis and locoregional recurrence [9]. However, prophylactic central lymph node dissection (CLND) has been reported to increase postoperative morbidity (transient hypocalcemia or recurrent laryngeal nerve paralysis) [10, 11], and the use of total thyroidectomy (TT) plus CLND is thus debated for PTMC, because prophylactic CLND may have little prognostic benefit and increase postoperative morbidity [12].…”

Section: Introductionmentioning

confidence: 99%

Influence of tumor extent on central lymph node metastasis in solitary papillary thyroid microcarcinomas: a retrospective study of 1092 patients

et al. 2017

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BackgroundThe morbidity of papillary thyroid microcarcinomas is increasing worldwide. Surgery is the main treatment for papillary thyroid microcarcinomas, and the choice of surgical method partly depends on the T stage of the tumor. However, according to the American Joint Commission on Cancer staging system (7th edition), the T stage of papillary thyroid microcarcinomas with different tumor extent is unclear. We aimed to study the effect of tumor extent and other factors on central lymph node metastasis to explore the relationship between tumor extent and T stage and to identify the risk factors predicting central lymph node metastasis in papillary thyroid microcarcinomas.MethodsWe included 1092 patients diagnosed with solitary papillary thyroid microcarcinomas between July 2011 and April 2016. The tumor extent and other central lymph node metastasis risk factors were retrospectively analyzed.ResultsUnivariate analysis revealed that capsule invasion and extracapsular extension (P = 0.013, <0.001; respectively) were significantly correlated with central lymph node metastasis. On multivariate analysis, extracapsular extension was independent central lymph node metastasis predictors (odds ratio 3.092, 95% CI 1.744–5.484), while capsule invasion was not (odds ratio 1.212, 95% CI 0.890–1.651). In addition, multivariate analysis revealed that male sex, tumor size >5 mm, and age <45 years were independent central lymph node metastasis predictors (odds ratio 2.072, 2.356, 2.302; 95% CI 1.483–2.894, 1.792–3.099, 1.748–3.031; respectively).ConclusionsThis study supported that capsule invasion and tumor limited to the thyroid in papillary thyroid microcarcinomas were suitable for the lower T1, that is, capsule invasion in papillary thyroid microcarcinomas might not belong to the minimal extrathyroid extension included in T3 of TNM staging. In addition, patients with risk factors of extrathyroid extension, male sex, age <45 years, or tumor size >5 mm in papillary thyroid microcarcinomas should consider a more aggressive surgical treatment.

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Section: Introductionmentioning

confidence: 99%

Influence of tumor extent on central lymph node metastasis in solitary papillary thyroid microcarcinomas: a retrospective study of 1092 patients

et al. 2017

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“…In a study conducted in 1961, TC patients whose disease extended beyond the capsule of the thyroid gland to the regional lymph nodes, surrounding organs or tissues, etc., had a much higher survival rate than that of other groups at 20 years after surgery (21). On the contrary, recent study results suggest that the lymph node involvement have a bad effect on the prognosis of TC (22,23). Whereas in such a situation, there is still not much attention paid to the investigation on the survival outcomes of patients with different lymph node stages, especially for the NX stage.…”

Section: Discussionmentioning

confidence: 83%

The Association Between Lymph Node Stage and Clinical Prognosis in Thyroid Cancer

et al. 2020

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Purpose: To investigate the association between lymph node (N) stage and clinical outcome in thyroid cancer patients with initial distant metastasis. Methods: A total of 3,198 cases (1,435 males and 1,763 females) between 2004 and 2015 with initial distant metastasis were obtained from the surveillance, epidemiology, and end results (SEER) database. Patients with a median follow up time of 13 months and a median age of 66 years were analyzed. A total of 1,407 cases had detailed information regarding the four most common metastatic organs after the year 2010. Kaplan-Meier (KM) analyses, log-rank tests, Cox regression, and logistic regression analyses were used.

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“…Extrathyroidal extension (ETE) in thyroid cancer is also a well‐known risk factor for cervical LN metastasis in PTMC. Recent studies have reported that PTMC with ETE has an increased risk of LCLN metastasis . In this study, we focused only on the pre‐operative features of PTMCs and did not evaluate any potential association between ETE and the risk of LCLN metastasis.…”

Section: Discussionmentioning

confidence: 99%

“…Recent studies have reported that PTMC with ETE has an increased risk of LCLN metastasis. 14,24,27 In this study, we focused only on the pre-operative features of PTMCs and did not evaluate any potential association between ETE and the risk of LCLN metastasis. However, a subcapsular location, defined as thyroid nodules abutting on the thyroid capsule on US imaging, may be a pre-operative imaging biomarker indicative of ETE.…”

Section: Discussionmentioning

confidence: 99%

Features of papillary thyroid microcarcinoma associated with lateral cervical lymph node metastasis

Jeon

Chung

Kwon

et al. 2017

Clinical Endocrinology

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Predictive Factors for Lymph Node Metastasis in Papillary Thyroid Microcarcinoma

Abstract: Meticulous perioperative evaluation of LN metastasis is required for PTMC patients with the above predictors.

Cited by 94 publications

References 40 publications

Influence of tumor extent on central lymph node metastasis in solitary papillary thyroid microcarcinomas: a retrospective study of 1092 patients

Influence of tumor extent on central lymph node metastasis in solitary papillary thyroid microcarcinomas: a retrospective study of 1092 patients

The Association Between Lymph Node Stage and Clinical Prognosis in Thyroid Cancer

Features of papillary thyroid microcarcinoma associated with lateral cervical lymph node metastasis

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