Relationship between pretracheal and/or prelaryngeal lymph node metastasis and paratracheal and lateral lymph node metastasis of papillary thyroid carcinoma: A meta-analysis

Abstract

ObjectiveWe conducted a meta-analysis to study the relationship between pretracheal and/or prelaryngeal lymph node metastasis and paratracheal and lateral lymph node metastasis in papillary thyroid carcinoma.MethodA systematic literature search was conducted using PubMed, Embase, and the Cochrane Library electronic databases for studies published up to February 2022. The reference lists of retrieved articles were also reviewed. Two authors independently assessed the methodological quality and extracted the data. A random-effects model was used to calculate the overall pooled relative risk. Publication bias in these studies was evaluated using Egger’s test and Begg’s test.ResultsTwenty-five independent studies involving 10,525 patients were included in the meta-analysis. The pooled relative risk for ipsilateral and contralateral paratracheal lymph node metastasis was 3.01 (95% confidence interval [CI]: 1.66, 5.45) and 5.68 (95% CI: 2.50, 12.88), respectively, in patients with pretracheal lymph node metastasis. Among patients with prelaryngeal lymph node metastasis, the pooled relative risk for ipsilateral paratracheal and/or pretracheal contralateral paratracheal, and lateral lymph node metastasis was 2.02 (95% CI: 1.90, 2.14), 2.22 (95% CI: 1.34, 3.67), and 3.85 (95% CI: 2.89, 5.14), respectively.ConclusionPretracheal lymph node metastasis and prelaryngeal lymph node metastasis were significantly associated with an increased likelihood of both ipsilateral lymph node metastasis and contralateral paratracheal lymph node metastasis in papillary thyroid carcinoma. Prelaryngeal lymph node metastasis was positively correlated with the incidence of lateral lymph node metastasis.

Prelaryngeal and/or pretracheal lymph node metastasis could help to identify papillary thyroid carcinoma with intermediate risk from unilateral lobe cT1-2N0 papillary thyroid carcinoma

“…The central lymph node consists of the prelaryngeal lymph node, pretracheal lymph node, and paratracheal (or tracheaesophageal groove) lymph node (5,6). In recent years, several studies explored the significance of prelaryngeal lymph node metastasis in PTC and found that prelaryngeal lymph node metastasis was positively associated with paratracheal and lateral lymph node metastasis (3,(7)(8)(9)(10). A similar result was obtained between pretracheal lymph node metastasis and paratracheal lymph node metastasis (6,11,12).…”

“…And the evidence that prelaryngeal lymph node metastasis was a poor prognostic factor in laryngeal and hypopharyngeal cancers gave enlightenment that it might affect the prognosis of PTC (19,20). Based on those, the significance of prelaryngeal and/or pretracheal lymph node metastasis in PTC was studied (3,10,17).…”

“…In consideration of the difference in the number between prelaryngeal lymph nodes and pretracheal lymph nodes, and the lack of study of the significance of a different number of metastatic lymph nodes, the predictive values of a combination of prelaryngeal lymph node metastasis and a different number of metastatic pretracheal lymph nodes were studied in the study. Due to the abundant intersecting lymph vessels and complex lymphatic drainage of the thyroid, there is no precise sentinel lymph node for thyroid carcinoma (10). As a part of perithyroidal lymph node metastasis, prelaryngeal and/or pretracheal lymph node metastasis was a reflection of ipsilateral central lymph node metastasis and a transfer station of contralateral central lymph node metastasis.…”

Elevated Levels of Interleukin-18 are Associated with Lymph Node Metastasis in Papillary Thyroid Carcinoma

“…Therefore, the strategy for manipulating IL-18 in cancer therapy should be carefully evaluated and may vary across different types of cancer. Second, for patients with PTC, the preoperative assessment of cervical lymph node metastasis is essential for determining the optimal surgical procedure 41 42 . The positive correlation between serum IL-18 levels and nodal metastasis of PTC, as demonstrated in our findings, suggests that serum IL-18 may serve as an ancillary biomarker for such assessment.…”

Meta-analysis of the effect and clinical significance of Delphian lymph node metastasis in papillary thyroid cancer

“…Previous studies have reported that anterior laryngeal lymph nodes are the sentinel lymph nodes of thyroid cancer and have a predictive effect on cervical lymph node metastasis. Furthermore, DLNM-positive patients have a higher rate of central group lymph nodes and lymph nodes in the lateral cervical region compared with that in DLNM-negative patients (15,19,36). Some original studies have reported that the detection rate of DLN is approximately 25.8%-76% (13,16,18,37) and the metastasis rate is approximately 12.4%-25.4% (13,14,(16)(17)(18)37).…”