Predictive Factors of Superior Mediastinal Nodal Metastasis from Papillary Thyroid Carcinoma—A Prospective Observational Study

Woo, Joo Hyun; Park, Ki Nam; Lee, Jae Yong; Lee, Seungwon

doi:10.1371/journal.pone.0148420

Cited by 9 publications

(15 citation statements)

References 21 publications

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“…Our study was the first study to present an analysis of predictive factors for Level VII LNM via video-assisted transcervical approach. Level VII LNM has been seen at variable incidence rates, ranging from 5.4 to 65% [7,[13][14][15], which is consistent with our study (28.73%). Previous studies suggested that many clinicopathological factors such as distant metastasis, greater total number of cervical LNM, tumor size, extrathyroidal extension, poorly differentiated carcinoma, and the age cut-off at 45 years were associated with Level VII LNM [7,8,13,14].…”

Section: Discussionsupporting

confidence: 91%

Identifying risk factors for metastasis to the level VII lymph node in papillary thyroid carcinoma patients

et al. 2020

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Background: The level VI lymph nodes are anatomically connected to the level VII lymph nodes and papillary thyroid carcinoma (PTC) can metastasis to both regions. The aim of this study was to identify clinicopathologic factors associated with level VII lymph node metastasis. Methods: Between March 2015 and September 2016, a total of 275 consecutive patients were operated on for PTC with prophylactic level VII dissection at the Sir Run Run . Patients with PTC were performed via video-assisted approach. Multivariate logistic regression analysis was performed to evaluate the associations between clinicopathologic factors. Results: Of the 275 subjects enrolled in this study, 79 patients (28.73%) showed lymph node metastasis to the level VII. The multivariate logistic regression analysis showed ultrasonography-positive lymph nodes (p < 0.001), the location of primary carcinoma (p = 0.002) and hashimoto thyroiditis (HT) (p = 0.04) were associated with level VII lymph node metastasis. Conclusions: Based on the results of our study, we considered central-compartment lymph node dissection (CLND) as an integral strategy. On the basis of surgery safety, transcervical level VII lymph node dissection could be considered for PTC patients with high risk factors such as ultrasonography-positive lymph nodes, tumor located in middle and lower thirds of the thyroid lobe and the patients without HT. In future, prognostic significance of level VII lymph node dissection should be evaluated through long-term surveillance.

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Section: Discussionsupporting

confidence: 91%

Identifying risk factors for metastasis to the level VII lymph node in papillary thyroid carcinoma patients

et al. 2020

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“…Thus, we applied the method of systematic literature review to investigate the incidence, predictive factors, and prognosis of mediastinal lymph node metastases in thyroid cancer. Through comprehensive search and reasonable scientific screening, 20 studies [ 6 – 25 ] were included finally ( Table 4 ).…”

Section: Resultsmentioning

confidence: 99%

“…All of the reference lists from the main articles were inspected for additional eligible studies. In total, 71 studies were retrieved and 20 studies [ 6 – 25 ] were finally included in the analysis according to the inclusion/exclusion criterions (detailed process of selection was shown in Figure 1(a) ).…”

Section: Methodsmentioning

confidence: 99%

Mediastinal Lymph Node Metastases in Thyroid Cancer: Characteristics, Predictive Factors, and Prognosis

Zhang

et al. 2017

International Journal of Endocrinology

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Background Mediastinal lymph node metastases (MLNM) have not been extensively studied. The aim of this study is to investigate the characteristics, predictive factors, and prognosis of MLNM in thyroid cancer. Methods This is a retrospective study based on the thyroid cancer patients with MLNM at our institution from 2008 to 2015. Results In total, 73 thyroid cancer patients with positive MLNM were included in this study. It contained sixty patients (82.2%) with papillary thyroid carcinoma (PTC), twelve (16.4%) with medullary thyroid carcinoma, and one (1.4%) with anaplastic thyroid carcinoma. Forty-eight patients had the surgery as initial treatment. Fifty-three (72.6%) patients remained disease-free, and fifteen (20.5%) developed a regional recurrence. Distant metastases occurred in four (5.5%) patients and five (6.8%) patients died. Five-year overall survival rate and disease-free survival (DFS) rate of the PTC patients for initial treatment are 95.4% and 77.2%, respectively. Extrathyroidal extension and multiple lymph nodes involved were associated with DFS in PTC patients. Conclusions Initial therapeutic control is very important for the thyroid cancer patients. Extrathyroidal extension and multiple mediastinal lymph nodes involved were the influence factors of prognosis in the thyroid cancer patients with MLNM.

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“…The risk of hypoparathyroidism can reach 30% (8% to 13%) in primary procedures [10]. Transient hypocalcaemia has been reported with an incidence of up to 30% [9], rates of hypoparathyroidism (transient, 31.8%; permanent, 3.6%) with preservation of blood supply to the parathyroid glands [11]. Re-thyroidectomies associated with a higher risk of postoperative complications [11].…”

Section: Discussionmentioning

confidence: 99%

“…Transient hypocalcaemia has been reported with an incidence of up to 30% [9], rates of hypoparathyroidism (transient, 31.8%; permanent, 3.6%) with preservation of blood supply to the parathyroid glands [11]. Re-thyroidectomies associated with a higher risk of postoperative complications [11]. Revision surgery of the central compartment places the parathyroid glands at an increased risk of devascularization or inadvertent removal [9].…”

Section: Discussionmentioning

confidence: 99%

Complication versus Radicality in Papillary Thyroid Cancer Surgery: How to Keep the Balance?

Zedan¹,

Ahmed²,

Omar³

et al. 2019

JCT

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Background: Controversy exists over the extent of surgical treatment of papillary thyroid cancer. Reoperations may carry a significant risk of surgical complications. The aim of this study is to investigate the complications following surgical treatment of thyroid cancer and the association between the extent of surgery and complication rates. Methods: A total of 196 patients with papillary thyroid cancer were retrospectively reviewed to identify extent of surgery and associated complications, between 2009 and 2018 at South Egypt Cancer Institute Assiut University. Results: Primary procedures included less-than-total thyroidectomy (near total thyroidectomy in 5.1%, subtotal thyroidectomy in 4.1%, thyroid lobectomy in 3.1%) and total thyroidectomy in 87.8% (18.9% of them are completion thyroidectomy). No lymph nodes dissection was done in 10.7%, Berry picking in 6.1%, central compartment neck dissection in 41.8%, central compartment neck dissection with modified ipsilateral radical neck dissection in 12.2%, central compartment neck dissection with modified bilateral radical neck dissection in 26.0%, central compartment dissection with both modified bilateral radical neck dissection and superior mediastinal lymph node dissection 3.1%. The most common surgical complication were transient hypoparathyroidism (16.7%-45.8%) and 2.0% permanent, transient vocal cord palsy (7.3%-16.7%), and 3.9% permanent, hematoma 1.5%, seroma 7.1% and chyle fistula in 2.6% of patients. Conclusion: Thyroid cancer surgeries are safe. The transient complication rates of hypoparathyroidism increased significantly with increasing the extent of surgery.

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Predictive Factors of Superior Mediastinal Nodal Metastasis from Papillary Thyroid Carcinoma—A Prospective Observational Study

Cited by 9 publications

References 21 publications

Identifying risk factors for metastasis to the level VII lymph node in papillary thyroid carcinoma patients

Identifying risk factors for metastasis to the level VII lymph node in papillary thyroid carcinoma patients

Mediastinal Lymph Node Metastases in Thyroid Cancer: Characteristics, Predictive Factors, and Prognosis

Complication versus Radicality in Papillary Thyroid Cancer Surgery: How to Keep the Balance?

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