Predictors of lymph nodes posterior to the right recurrent laryngeal nerve metastasis in patients with papillary thyroid carcinoma

Abstract

The aim of this study was to identify the risk factors associated with lymph nodes posterior to the right recurrent laryngeal nerve (LN-prRLN) metastasis in patients with papillary thyroid carcinoma (PTC).A total of 81 PTC patients who underwent total/near-total thyroidectomy with LN-prRLN dissection in the Department of General Surgery at Guangdong General Hospital between June 2015 and August 2016 were assessed retrospectively. The relations of LN-prRLN metastasis with clinicopathologic characteristics of PTC were analyzed by univariate and multivariate logistic regression.The incidence of LN-prRLN metastasis in patients with PTC was 51.9% (42 of 81 cases). Univariate analysis showed that lateral LN metastasis (P = .005), VIa central LN metastasis (P = .000), pathologic tumor size (P = .000), capsular invasion (P = .002), and extrathyroidal invasion (P = .018) (P < .05) were significantly associated with the increased incidence of LN-prRLN metastasis in PTC. No significant correlations were found between LN-prRLN metastasis and other variables such as gender (P = .056), age (P = .448), clinical N stage (cN) (P = .063), tumor location (P = .336), tumor site (P = .909), right tumor existence (P = .793), and multifocality (P = .381). Multivariate logistic regression analysis revealed that VIa central LN metastasis (OR: 4.490, P = .027) was independent risk factors of LN-prRLN metastasis in patients with PTC.LN-prRLN metastasis is often indentified in patients with PTC. VIa central LN metastasis is an independent predictors of LN-prRLN metastasis, which allow for selective LN-prRLN dissection in patients with PTC.

A Comparison of Two Operation Methods Revealed the Risk Factors and the Necessity of LN-prRLN Dissection in Papillary Thyroid Carcinoma: A Retrospective Cohort Study in FUSCC

“…However, ETE was not identified as an independent risk factor for LN-prRLN metastasis in the multivariable analysis (1.63 (0.70–3.84), P =0.258). This is consistent with findings reported by Yuan et al [ 9 ] and Bae et al [ 8 ].…”

“…Thus, the right paratracheal lymph node is further classified into two subregions by the right RLN [ 8 ]. The nodes located near the posterior side of the right nerve, upper to the esophagus and prevertebral fascia, are called the lymph nodes posterior to the right recurrent laryngeal nerve (LN-prRLN), which were defined as VIb compartments, and lymph nodes anterior to the right recurrent laryngeal nerve were defined as VIa compartments [ 9 ]. The reported prevalence of LN-prRLN metastasis varies from 5.76% to 26% [ 8 , 10 – 14 ].…”

Risk Factors for Predicting Lymph Nodes Posterior to Right Recurrent Laryngeal Nerve (LN-prRLN) Metastasis in Thyroid Papillary Carcinoma: A Meta-Analysis

“…Seven studies [7–12] included 3907 patients aged <45 years with PTC and 4507 aged ≥45 years with PTC (OR 1.314, 95% CI 1.111-1.554, I 2 = 0.0%, P = 0.001). There was a significant difference between the 2 variants (Figure 2).…”

“…Thirteen studies [7–19], comprising 11,104 patients, 1988 males and 8026 females, were included for analysis. In the gender analysis, compared with the women, the men had a higher risk of LN-prRLN metastasis (OR = 1.913, 95% CI 1.481-2.471, P < 0.001, I 2 = 46.8%) (Figure 3).…”

Risk Factors for Lymph Node Metastasis in Papillary Thyroid Carcinoma: A Systematic Review and Meta-Analysis

“…Although, PTC exhibit indolent behavior and bring a relatively low disease-specific mortality, with early-dissemination to local lymph nodes and oppression to organs, recurrence is comparatively common locally and distantly (14). In addition, the identification of risk factors of PTC is helpful for surgeons to evaluate the status of lymph nodes in PTC patients and determine whether preventive central lymph node dissection (CLND) is needed (15). Therefore, there is an urgent need for the identification risk factors that may predict the metastasis potential of these lesions and new prevention strategies.…”