Superior Located Papillary Thyroid Microcarcinoma is a Risk Factor for Lateral Lymph Node Metastasis

Back, Kyorim; Kim, Jee Soo; Kim, Jung-Han; Choe, Jun-Ho

doi:10.1245/s10434-019-07587-2

Cited by 41 publications

(46 citation statements)

References 29 publications

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“…However, the clinical stage of ETE belongs to T3, so we excluded ETE in this study. Tumor location at the superior pole and ipsilateral central lymph node positivity are also independent high-risk factors for lateral neck metastasis in PTMC patients, consistent with other studies [20,21] . However, our study did not find that sex, multifocality or age were high-risk factors for LNLN metastasis.…”

Section: Discussionsupporting

confidence: 90%

High-risk factors for ipsilateral lateral neck lymph node metastasis in clinically node-negative patients with papillary thyroid microcarcinoma (cT1aN0)

Zhou¹,

Lin²,

Qin³

2020

Preprint

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Background: The incidence of papillary thyroid microcarcinoma (PTMC) increases yearly. There are several studies on the high-risk factors for lymph node metastasis in the central compartment of PTMC but few studies on the high-risk factors for lateral neck lymph node (LNLN) metastasis. Few studies have analyzed the high-risk factors for LNLN metastasis for clinically lymph node-negative PTMC patients in stage T1a (cT1aN0). We investigated the risk factors for LNLN metastasis in these patients. Methods: In total, 127 PTMC (cT1aN0) patients underwent hemi-or total thyroidectomy with ipsilateral central lymph node dissection (CLND) plus lateral lymph node dissection (LLND), including levels III and IV, between 2018 and 2019 in our hospital. Univariate and multivariate analyses identified the high-risk factors for LNLN metastasis in PTMC (cT1aN0). Results: The rate of LNLN metastasis was 21.26% (27/127). The multivariate analysis showed that capsular invasion (p=0.027), tumor location at the superior pole (p=0.002) and ipsilateral central lymph node positivity (p=0.001) were independent risk factors for LNLN metastasis in PTMC patients (cT1aN0), with odds ratios (ORs) of 0.181 (95% confidence interval (95% CI): 0.039-0.827), 5.994 (95% CI: 1.949-18.435) and 6.182 (95% CI: 2.193-17.425), respectively. Conclusions: These findings indicate that capsular invasion, tumor location at the superior pole and ipsilateral central lymph node positivity are independent high-risk factors for LNLN metastasis in clinically node-negative PTMC (cT1aN0) patients. High-risk factors should be correctly evaluated to guide surgical treatment for PTMC patients.

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Section: Discussionsupporting

confidence: 90%

High-risk factors for ipsilateral lateral neck lymph node metastasis in clinically node-negative patients with papillary thyroid microcarcinoma (cT1aN0)

Zhou¹,

Lin²,

Qin³

2020

Preprint

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“…In addition, US suspicion of ETE is barely reproducible between different examiners 44 . It was reported that superior pole location, age <45 years, 45 Hashimoto's thyroiditis, the presence of microcalcifications, and central lymph node metastasis 46 were independent predictors of lateral neck metastasis, while superior pole location, and central lymph node metastasis were significant risk factors for local recurrence 45 …”

Section: Risk Stratification Of Papillary Thryoid Microcarcinomamentioning

confidence: 99%

“…44 It was reported that superior pole location, age <45 years, 45 Hashimoto's thyroiditis, the presence of microcalcifications, and central lymph node metastasis 46 were independent predictors of lateral neck metastasis, while superior pole location, and central lymph node metastasis were significant risk factors for local recurrence. 45 Several studies have associated BRAF V600E with prognostic factors generally related to aggressive behavior and persistent disease in patients with microPTC, although these results are not consistent. In a multicenter study, Tallini et al 39 confirmed that microPTCs are a heterogeneous group and that it is inaccurate to consider them as a single category.…”

Section: Risk Stratification Of Papillary Thryoid Microcarcinomamentioning

confidence: 99%

Low‐risk papillary thyroid microcarcinoma: Optimal management toward a more conservative approach

Ramundo

Sponziello

Falcone

et al. 2020

Journal of Surgical Oncology

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The incidence of papillary thyroid microcarcinoma (microPTC) has dramatically increased in the last decades. Most of these tumors remain small and clinically “silent”, only small number progress. Although thyroid surgery used to be the only therapeutic approach, recent guidelines now consider active surveillance for low‐risk microPTC. For this reason, more accurate risk stratification of microPTC is needed. The optimal management of low‐risk microPTC through accurate risk stratification represents a major clinical issue.

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“…The effect of age on lateral LNM remained contradictory. Age under 45 years has been reported to be associated with lateral LNM, 22 while, age ≥45 years was considered to be an independent risk factor for LNM in the PTC with lateral lymph node metastasis. 23,24 In this study, age ≥47 years was considered as a strong marker for predicting SLNM.…”

Section: Discussionmentioning

confidence: 98%

“…Statistical software SPSS 22.0 was used to analyze the data. Continuous variables are presented as mean ± standard deviation.…”

Section: Discussionmentioning

confidence: 99%

<p>Preoperative Sonographic and Clinicopathological Predictors for Solitary Lateral Neck Node Metastasis in Papillary Thyroid Carcinoma: A Retrospective Study</p>

Yang

Chen

et al. 2020

CMAR

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Background: Cervical lymph node metastasis (LNM) is an independent risk factor for poor prognosis of papillary thyroid carcinoma (PTC), but the scope of PTC lateral neck dissection (LND) is controversial. Solitary lateral lymph node metastasis (SLNM) is a special type of PTC with lateral LNM. Currently, study on the preoperative clinical characteristics of SLNM has been seldomly reported. This study evaluated the preoperative characteristics for predicting the SLNM of PTC. Methods: We included 391 patients diagnosed with PTC between May 2011 and July 2017. Among those patients, 44 had SLNM and 347 had multiple lateral neck node metastasis (MLNM). The clinicopathologic characteristics and other central lymph node metastasis risk factors were retrospectively analyzed. Results: Univariate analysis revealed that age and tumor size (≤1 cm) were significantly correlated with SLNM. In ROC curve analysis, the optimal cutoff age of preoperative predictors for the prediction of SLNM was 46.5 years (AUC=0.623, 0.536-0.710). Besides, the frequency and mean number of CLNM was significantly less in the SLNM than MLNM group. The oval and round tumor shape and well-defined margin of the tumor were more common in the SLNM group (p =0.001; p=0.024, respectively). In addition, multivariate analysis revealed that age ≥47, capsular invasion, no extrathyroidal extension, with central lymph node metastases and irregular shape were independent SLNM predictors of PTCs (odds ratio 2.386, 0.173, 0.284, 0.239, 0.188; 95%

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Superior Located Papillary Thyroid Microcarcinoma is a Risk Factor for Lateral Lymph Node Metastasis

Cited by 41 publications

References 29 publications

High-risk factors for ipsilateral lateral neck lymph node metastasis in clinically node-negative patients with papillary thyroid microcarcinoma (cT1aN0)

High-risk factors for ipsilateral lateral neck lymph node metastasis in clinically node-negative patients with papillary thyroid microcarcinoma (cT1aN0)

Low‐risk papillary thyroid microcarcinoma: Optimal management toward a more conservative approach

<p>Preoperative Sonographic and Clinicopathological Predictors for Solitary Lateral Neck Node Metastasis in Papillary Thyroid Carcinoma: A Retrospective Study</p>

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