Risk Factors for Nodal Metastasis and Recurrence Among Patients with Papillary Thyroid Microcarcinoma: Differences in Clinical Relevance Between Nonincidental and Incidental Tumors

Pisanu, Adolfo; Reccia, Isabella; Nardello, Oreste; Uccheddu, A

doi:10.1007/s00268-008-9870-8

Cited by 80 publications

(73 citation statements)

References 49 publications

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“…Given that CLNM is among the most significant risk factors in predicting locoregional recurrences (4,8,9), the American Thyroid Association (ATA) strongly recommends therapeutic central neck dissection in PTMCs with evidence of CLNM (10). However, diagnosing CLNM only through preoperative imaging is difficult.…”

Section: Discussionmentioning

confidence: 99%

“…Given that central neck lymph node metastasis (CLNM) is the most significant risk factor in predicting locoregional recurrences (4,8,9), therapeutic central neck dissection is necessary if CLNM is detected in preoperative examination (10). However, whether prophylactic central neck lymph node dissection (CLND) improves survival rate and prognosis in patients without confirmed CLNM in preoperative examination is yet to be determined.…”

Section: Introductionmentioning

confidence: 99%

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Predictive Factors for Central Neck Lymph Node Metastasis in Patients with Papillary Thyroid Microcarcinoma without Suspicious Metastasis by Preoperative Ultrasonography

Jeong

Kim

2017

J Endocr Surg

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Purpose: We aimed to determine the influencing factors for central neck lymph node metastasis (CLNM) in papillary thyroid microcarcinoma (PTMC) without clinical evidence of metastasis on preoperative ultrasonography. Methods: We retrospectively analyzed 625 patients with PTMC who underwent thyroid surgery at Chosun University Hospital from January 2002 to December 2012. A total of 575 patients who had no evidence of lymph node metastasis by preoperative ultrasonography were included in the study. Medical records, including clinical information and pathologic report, were reviewed. Results: Central lymph node metastasis was found in 81 (14.1%) out of 575 patients. Results of univariate analysis indicated that lymph node metastasis occurred frequently in patients with more than 0.5 cm largest tumor size by preoperative sonography and pathologic reports (P=0.048 and P=0.001, respectively) and lymphovascular invasion (LVI) (P<0.001). Multivariate analysis revealed that sex (female vs. male), pathologic tumor size (0.5-1.0 cm vs. <0.5 cm), and LVI (yes vs. no) were significantly associated with lymph node metastasis (odds ratio [OR], 0.498, 95% confidence interval [CI], P=0.047; OR, 2.450, 95% CI, P=0.005; and OR, 24.954, 95% CI, P=0.007, respectively). Conclusion: Male sex, large tumor size (≥0.5 cm), and LVI were the risk factors for CLNM in patients with PTMC without clinical evidence of node metastasis. Prophylactic central neck lymph node dissection (CLND) might be required in these cases of PTMC.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Predictive Factors for Central Neck Lymph Node Metastasis in Patients with Papillary Thyroid Microcarcinoma without Suspicious Metastasis by Preoperative Ultrasonography

Jeong

Kim

2017

J Endocr Surg

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“…In this study it was 21% (147/709). Pisanu et al (2009) reported 149 cases of tiny PTC, in which there were 73 cases of incidental groups, non-episodic 76 cases, average tumor diameters of two groups were 4.2mm and 7.5mm. To date, detailed studies of the biologic behaviors of IPC have not been performed.…”

Section: Discussionmentioning

confidence: 99%

“…Nonpalpable nodules have the same risk of malignancy as palpable nodules (Hagag et al, 1998;Lin et al, 2005;Pang and Chen, 2007). The incidence of thyroid carcinoma, which is diagnosed via the surgery for benign thyroid disease or postoperative pathology, also have showed a clear upward trend in recent years (Pang and Chen, 2007;Alevizaki et al, 2009;Pisanu et al, 2009;Lombardi et al, 2010). It is reported that the ratio of multiple nodular goiter with malignant tumors about 4% -17% (Koh and Chang, 1992).…”

Section: Introductionmentioning

confidence: 99%

“…Arora et al (2009) believed there exist some differences between the occasional thyroid microcarcinoma and tiny carcinoma from clinical findings, the invasiveness of the latter is higher. Incidental thyroid carcinoma should recieve a clinical close follow-up or positive surgical (total thyroidectomy + neck lymph node dissection) or other treatments, there has not been determined (Ito et al, 2007;Sakorafas et al, 2007;Dralle et al, 2009;Pisanu et al, 2009;Lombardi et al, 2010;Papini et al, 2011). Sokal (1957) suggest that the incidence of carcinoma in non-toxic thyroid nodules is low and patients can be followed up safely for up to 15 years.…”

Section: Introductionmentioning

confidence: 99%

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Clinical Features and Prognosis of Patients with Benign Thyroid Disease Accompanied by an Incidental Papillary Carcinoma

Wang¹,

Zhao²,

Wang³

et al. 2013

Asian Pacific Journal of Cancer Prevention

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Purpose: To investigate the clinical features and prognosis of papillary thyroid carcinoma (PTC) with a background of benign disease. Method: A total of 709 patients with papillary thyroid carcinoma undergoing surgical resection were analyzed retrospectively. In 147 patients who underwent surgery for benign thyroid disease, incidental PTC (IPC group) were identified by intraoperative or postoperative pathological examination of surgical specimens but were not detected by preoperative imaging studies. In the other group, according to the pathological examination with or without co-existing benign thyroid disease, 253 cases were clarified as concomitant PTC and 309 cases were clarified as dominant PTC. Results: Incidental PTC was more common in women, about 85.7%, the mean age was 47.6±11.3 years old. Average tumor diameter was 4.4±2.2 mm, multiple lesions accounted for 12.9% (19/147), and the cervical lymph node metastasis rate was 6.1% (9/147). After radical resection 8 cases recurred, the median time of recurrence was about 12 months (0.5 to 162), there was no tumor-related death. The tumor-free survival rates were 97.3%, 95.9%, 91.5%, and 79.3% in 1, 5, 10 and 14 year respectively. Conclusion: Incidental PTC with a background of benign lesions is common, and the generally good prognosis can be attributed to tumor early detection and early treatment. On the intraoperative finding of incidental PTC, lobectomy (unilateral) or total thyroidectomy (bilateral) should be the first choice, but with a postoperative pathologic finding of incidental PTC, further treatment, such as completion thyroidectomy or immediate lymph dissection is not necessary. Central lymph node dissection is also not needed unless lymphadenectasis is present.

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Thyroid Cancer

Carr¹

2019

Cancer

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Risk Factors for Nodal Metastasis and Recurrence Among Patients with Papillary Thyroid Microcarcinoma: Differences in Clinical Relevance Between Nonincidental and Incidental Tumors

Abstract: Several PMCs presented with risk-free clinical courses. Some nonincidental tumors had a more aggressive behavior and a tendency to recurrence. In these cases, early detection and aggressive treatment are mandatory as for conventional PTC according to risk stratification and cancer stage.

Cited by 80 publications

References 49 publications

Predictive Factors for Central Neck Lymph Node Metastasis in Patients with Papillary Thyroid Microcarcinoma without Suspicious Metastasis by Preoperative Ultrasonography

Predictive Factors for Central Neck Lymph Node Metastasis in Patients with Papillary Thyroid Microcarcinoma without Suspicious Metastasis by Preoperative Ultrasonography

Clinical Features and Prognosis of Patients with Benign Thyroid Disease Accompanied by an Incidental Papillary Carcinoma

Thyroid Cancer

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