Risk Factors for Lateral Cervical Lymph Node Involvement in Follicular Thyroid Carcinoma

Alfalah, Haitham; Cranshaw, Isaac; Jany, T.; Arnalsteen, Laurent; Leteurtre, Emmanuelle; Cardot, Catherine; Pattou, François; Carnaille, B.

doi:10.1007/s00268-008-9742-2

Cited by 32 publications

(19 citation statements)

References 39 publications

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“…Pediatric FTC may be less aggressive than PTC and is generally associated with less advanced disease, fewer distant metastases, and a lower rate of recurrence (9,11,50,167,376). Except for the aggressive variants, FTC is typically a unifocal tumor that rarely spreads to regional lymph nodes (11,25,50,51,358,372,(376)(377)(378)(379) and may have autonomous function (380)(381)(382). However, unlike PTC, FTC is prone to early hematogenous metastases, which occurs even in the absence of cervical node involvement (383,384).…”

Section: Recommendation Rating: C [E1] Follicular Thyroid Cancermentioning

confidence: 99%

Management Guidelines for Children with Thyroid Nodules and Differentiated Thyroid Cancer

Francis

Waguespack

Bauer

et al. 2015

Thyroid

1,011

1,365

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Background: Previous guidelines for the management of thyroid nodules and cancers were geared toward adults. Compared with thyroid neoplasms in adults, however, those in the pediatric population exhibit differences in pathophysiology, clinical presentation, and long-term outcomes. Furthermore, therapy that may be recommended for an adult may not be appropriate for a child who is at low risk for death but at higher risk for long-term harm from overly aggressive treatment. For these reasons, unique guidelines for children and adolescents with thyroid tumors are needed. Methods: A task force commissioned by the American Thyroid Association (ATA) developed a series of clinically relevant questions pertaining to the management of children with thyroid nodules and differentiated thyroid cancer (DTC). Using an extensive literature search, primarily focused on studies that included subjects £ 18 years of age, the task force identified and reviewed relevant articles through April 2014. Recommendations were made based upon scientific evidence and expert opinion and were graded using a modified schema from the United States Preventive Services Task Force. Results: These inaugural guidelines provide recommendations for the evaluation and management of thyroid nodules in children and adolescents, including the role and interpretation of ultrasound, fine-needle aspiration cytology, and the management of benign nodules. Recommendations for the evaluation, treatment, and follow-up of children and adolescents with DTC are outlined and include preoperative staging, surgical management, postoperative staging, the role of radioactive iodine therapy, and goals for thyrotropin suppression. Management algorithms are proposed and separate recommendations for papillary and follicular thyroid cancers are provided.

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Section: Recommendation Rating: C [E1] Follicular Thyroid Cancermentioning

confidence: 99%

Management Guidelines for Children with Thyroid Nodules and Differentiated Thyroid Cancer

Francis

Waguespack

Bauer

et al. 2015

Thyroid

1,011

1,365

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“…Prophylactic neck dissection in follicular thyroid carcinoma is not indicated as only 1–8% of patients will have lymph node metastases [21]. Prophylactic central lymph node dissection with total thyroidectomy for the treatment of PTC in the clinical absence of neck metastases is controversial because of the possibility of increased morbidity with uncertain benefit in clinical outcomes.…”

Section: Discussionmentioning

confidence: 99%

“…Both pre-and intraoperative assessment of the central compartment have been shown to be unreliable in detecting microscopic nodal metastases [22] and, therefore, pathological analysis of a central neck dissection specimen can be used to refine the staging of PTC. Up to 60% of patients undergoing prophylactic central neck dissection will have pathological evidence of subclinical nodal metastases [21]. As the current staging system stands, this finding will subsequently upstage those patients aged 45 years or older [21,23].…”

Section: Discussionmentioning

confidence: 99%

“…Up to 60% of patients undergoing prophylactic central neck dissection will have pathological evidence of subclinical nodal metastases [21]. As the current staging system stands, this finding will subsequently upstage those patients aged 45 years or older [21,23]. This information has been used by some groups to target patients for adjuvant radioactive iodine (RAI) or for administration of higher RAI doses in centres that use adjuvant RAI routinely [23].…”

Section: Discussionmentioning

confidence: 99%

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Differentiated and Medullary Thyroid Cancer: Surgical Management of Cervical Lymph Nodes

2017

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Thyroid cancer metastasises to the central and lateral compartments of the neck frequently and early. The impact of nodal metastases on outcome is affected by the histological subtype of the primary tumour and the patient’s age, as well as the size, number and location of those metastases. The impact of extranodal extension has recently been highlighted as an important prognosticating factor. Although clinically evident nodal disease in the lateral neck compartments has a significant impact on both survival and recurrence, microscopic metastases to the central or the lateral neck in well-differentiated thyroid cancer do not significantly affect outcome. Here we discuss the surgical management of neck metastases in well-differentiated and medullary thyroid carcinoma.

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“…Die Empfehlungen der ATA aus 2009 und einiger Autoren lauten [1], dass man "bei den meisten" FTC unter 4 cm auf eine Lymphadenektomie verzichten kann, der Evidenzgrad ist allerdings niedrig und ba siert auf Expertenmeinung.…”

Section: Keine Lymphadenektomie Beim Follikulären Karzinomunclassified

Minimally invasive follicular thyroid carcinoma

Hermann¹,

Tonninger²,

Kober³

et al. 2010

Chirurg

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Current treatment guidelines for follicular thyroid carcinoma (FTC) recommend total thyroidectomy, lymphadenectomy and radioiodine ablation. Considering the low malignant potential of minimally invasive follicular thyroid carcinoma (MIFTC), a limited radical therapeutic procedure may be adequate. MIFTC is an intensely discussed group of tumors and a review of the literature reveals disagreement among experts concerning the criteria for a distinct definition. Therefore, in 2005 Rosai proposed a clinically more significant classification of FTC based on the extent of capsular and vascular invasion: MIFTC with capsular invasion only, with limited (< or =3) vascular invasion, encapsulated FTC with extensive (>3) vascular invasion and broadly invasive FTC with extensive invasive growth.For the diagnosis of MIFTC a complete investigation of the encapsulated follicular lesion should be performed by the pathologist and examination of at least 10 tissue blocks is mandatory. Due to the excellent prognosis hemithyroidectomy constitutes an adequate therapeutic approach in MIFTC with capsular invasion only and may also be considered for MIFTC with limited vascular invasion. There are no indications for systematic lymphadenectomy.

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Risk Factors for Lateral Cervical Lymph Node Involvement in Follicular Thyroid Carcinoma

Abstract: Follicular thyroid carcinoma results in metastases to regional lymph nodes in 7% of cases but only to the ipsilateral neck side. Tumor size is the only factor that impacts it. We do not recommend lymph node dissection in follicular thyroid carcinomas <4 cm.

Cited by 32 publications

References 39 publications

Management Guidelines for Children with Thyroid Nodules and Differentiated Thyroid Cancer

Management Guidelines for Children with Thyroid Nodules and Differentiated Thyroid Cancer

Differentiated and Medullary Thyroid Cancer: Surgical Management of Cervical Lymph Nodes

Minimally invasive follicular thyroid carcinoma

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