Risk factors for contralateral central lymph node metastasis in unilateral cN0 papillary thyroid carcinoma: A meta-analysis

Yan, Binbin; Hou, Ying-Chen Claire; Chen, Dong; He, Jie; Jiang, Yuxin

doi:10.1016/j.ijsu.2018.09.004

Cited by 45 publications

(31 citation statements)

References 40 publications

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“…After the multivariate analysis, four variables including tumor location (low), high level of TgAb (>1,150 IU/ml), the irregular margin of CLN, and micro-calcification in the CLN were independent risk factors in promoting CLM in patients with HT. However, in PTC patients with HT, we did not successfully validate the clinical factors which were previously confirmed significantly associated with the CLNM like male gender, large tumor size, age <55 years, or multifocality (27,32,33). Possible reasons were the relatively small sample size, the different including criteria, and study setting compared with our previous work on predicting the cervical lymph node metastasis in classic PTC patients (34).…”

Section: Discussionmentioning

confidence: 66%

Preoperatively Predicting the Central Lymph Node Metastasis for Papillary Thyroid Cancer Patients With Hashimoto’s Thyroiditis

et al. 2021

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BackgroundThe preoperative distinguishment of lymph nodes with reactive hyperplasia or tumor metastasis plays a pivotal role in guiding the surgical extension for papillary thyroid carcinoma (PTC) with Hashimoto’s thyroiditis (HT), especially in terms of the central lymph node (CLN) dissection. We aim to identify the preparative risk factors for CLN metastasis in PTC patients concurrent with HT.Materials and MethodsWe retrospectively reviewed and analyzed the data including the basic information, preoperative sonographic characteristics, and thyroid function of consecutive PTC patients with HT in our medical center between Jan 2019 and Apr 2021. The Chi-square and Fisher’s exact tests were used for comparison of qualitative variables among patients with or without CLN metastasis. Univariate and multivariate logistic regression analyses were used to determine the risk factors for CLN metastasis. The nomogram was constructed and further evaluated by two cohorts produced by 1,000 resampling bootstrap analysis.ResultsA total of 98 in 214 (45.8%) PTC patients were identified with CLN metastasis. In multivariate analysis, four variables including high serum thyroglobulin antibody (TgAb) level (>1,150 IU/ml), lower tumor location, irregular margin of CLN, and micro-calcification in the CLN were determined to be significantly associated with the CLN metastasis in PTC patients with HT. An individualized nomogram was consequently established with a favorable C-index of 0.815 and verified via two internal validation cohorts.ConclusionsOur results indicated that preoperatively sonographic characteristics of the tumor and lymph node condition combined with serum TgAb level can significantly predict the CLN in PTC patients with HT and the novel nomogram may further help surgeons to manage the CLN in this subpopulation.

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Section: Discussionmentioning

confidence: 66%

Preoperatively Predicting the Central Lymph Node Metastasis for Papillary Thyroid Cancer Patients With Hashimoto’s Thyroiditis

et al. 2021

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“…In accordance with the American Joint Committee on Cancer staging system, irrespective of the tumor size, patients with ETE were classified into T3 or T4. Thus, ETE represents one of the main characteristics of an advanced primary tumor, and these patients are supposed to undergo more radically surgical treatment; furthermore, the presence of ETE is usually associated with reduced disease-free survival ( 2 , 23 , 24 ). Sun et al.…”

Section: Discussionmentioning

confidence: 99%

Unnecessity of Routine Dissection of Right Central Lymph Nodes in cN0 Papillary Thyroid Carcinoma Located at the Left Thyroid Lobe

Zhang

Wang

et al. 2021

Front. Oncol.

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ObjectiveThe lymph node posterior to the right recurrent laryngeal nerve (LN-prRLN) is an important part of the central lymph nodes (LNs). We aimed to explore the rate and predictors of LN-prRLN metastasis in cN0 papillary thyroid carcinoma (PTC) located at the left thyroid lobe.MethodsPatients with surgically treated primary left lobe PTC were retrospectively enrolled. The metastatic distribution of LN-prRLN and postoperative complications were assessed. The association between LN-prRLN metastasis and clinicopathological variables was evaluated by univariate and multivariate analyses.ResultsA total of 857 patients were included for the analysis. Central LN metastasis was noted in 310 (35.3%) cases. The most (27.6%) and least (1.7%) commonly involved LNs were the left paratracheal LN and the LN-prRLN. In the univariate analysis, the tumor size, multifocality, the extent of extrathyroidal extension (none vs. macroscopic vs. macroscopic maximal), and perineural invasion were associated with positive LN-prRLN. In the multivariate analysis, tumor size of >40.0 mm and macroscopic maximal invasion were found as the only two independent predictors. Transient and permanent hypoparathyroidism were noted in 90 (10.2%) and 13 (1.5%) patients, respectively. Voice change was noted in 40 (4.6%) patients, and 20 patients recovered.ConclusionsIn cN0 PTC located at the left lobe, LN-prRLN metastasis was very uncommon. We found that LN-prRLN dissection is not required routinely, but should be performed if the tumor size is >40.0 mm and macroscopic maximal extrathyroidal extension is present.

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“…Besides, a relatively smaller sample size compared with other large cohort studies also contributed to this difference. Hence, gender, age, tumor size, and HT were nally screened out for multivariable analysis, similar to the recently reported studies 28,29 . Interestingly, it's believed that tumor size was one of the pivotal risk factors in CLNM and the risk of CLNM increased as the diameter of the primary nodule increases.…”

Section: Discussionmentioning

confidence: 99%

A Nomogram Predicting Central Lymph Node Metastasis for Patients with Papillary Thyroid Cancer

Min¹,

Feng²,

Xiang³

et al. 2021

Preprint

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PurposeCentral lymph node metastasis (CLNM) has been regarded as a predictor of relatively poor prognosis in patients with papillary thyroid carcinoma (PTC). Our study aimed to identify the risk factors for CLNM and develop a nomogram helping clinical decisions.MethodA total of 1,054 patients underwent thyroidectomy between January 2019 and September 2020 in the Second Affiliated Hospital of Chongqing Medical University. Among these patients, 747 patients with histopathologically confirmed PTC were included in this retrospective study. The perioperative clinical data of these patients were reviewed and analyzed. Univariate and multivariate logistic regression were used to analyze the correlation between clinicopathological characteristics and CLNM. A nomogram model was subsequently established and validated by a decision curve analysis (DCA) curve.Result33.6% (251/747) patients with PTC were confirmed with CLNM. And the CLNM was determined in 31.4% (168/535) non- Hashimoto’s thyroiditis (HT) patients and 39.2% (83/212) HT patients, respectively. 4 clinicopathological factors including gender, age, size, and HT were confirmed significantly associated with CLNM. The established nomogram showed promising discrimination and consistency in the study group with a C-index of 0.703. The decision curve analysis showed the nomogram has clinical feasibility.ConclusionOur data suggested that male gender, younger age, larger tumor size, and HT condition played a pivotal role in promoting the CLNM of PTC patients. And the nomogram we developed can help surgeons make the individualized clinical decision in PTC patients during preoperative and interoperative management.

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Risk factors for contralateral central lymph node metastasis in unilateral cN0 papillary thyroid carcinoma: A meta-analysis

Cited by 45 publications

References 40 publications

Preoperatively Predicting the Central Lymph Node Metastasis for Papillary Thyroid Cancer Patients With Hashimoto’s Thyroiditis

Preoperatively Predicting the Central Lymph Node Metastasis for Papillary Thyroid Cancer Patients With Hashimoto’s Thyroiditis

Unnecessity of Routine Dissection of Right Central Lymph Nodes in cN0 Papillary Thyroid Carcinoma Located at the Left Thyroid Lobe

A Nomogram Predicting Central Lymph Node Metastasis for Patients with Papillary Thyroid Cancer

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