The relevance of preoperative ultrasound cervical mapping in patients with thyroid cancer

Kocharyan, Davit; Schwenter, Frank; Bélair, Manon; Nassif, Edgard

doi:10.1503/cjs.011015

Cited by 10 publications

(6 citation statements)

References 32 publications

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“…Our results confirmed that U/S mapping is a highly reliable and accurate tool in identifying metastatic LN and guiding the surgeon for precise neck dissection. In our study, all lateral metastatic neck LN were identified preoperatively, and our high sensitivity and specificity are in agreement with other published studies [43].…”

Section: Discussionsupporting

confidence: 93%

Lymph Node Metastasis and Extrathyroidal Extension in Papillary Thyroid Microcarcinoma in Cyprus: Suspicious Subcentimeter Nodules Should Undergo FNA When Multifocality is Suspected

Papaioannou

Lamnisos

Kyriacou³

et al. 2020

Journal of Thyroid Research

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Objective. To determine the prevalence of lymph node (LN) metastasis and extrathyroidal extension (ETE) in patients with papillary thyroid microcarcinoma (PTMC) in Cyprus and to evaluate the role of preoperative ultrasound (U/S) examination. Methods. A retrospective study of 102 patients who underwent thyroidectomy for PTMC in a 2-year period. Preoperatively, all patients had a thyroid and neck U/S examination with LN mapping. Tumor size according to the largest diameter, number of foci, LN metastasis, and ETE data was collected from the histopathological report and was compared to the preoperative U/S reports. Results. LN metastasis was present in 23.5% of patients. 15.7% had central, 3.9% had lateral, and 3.9% had both central and lateral LN metastasis. ETE was present in 27.5% of patients. 21.6% had multifocal disease, and in this group, 40.9% had LN metastasis and 36.4% had ETE. Multifocality (p=0.03), size of tumor (p=0.05), and ETE (p≤0.001) were significantly associated with LN metastasis. The prevalence of LN metastasis in multifocal PTMC ≤5 mm was the same with multifocal PTMC >5 mm. The preoperative U/S sensitivity for the suspicious lateral neck and central LN was 100%, and the specificity was 100%. The preoperative U/S sensitivity for nodules suspicious for ETE was 53.6%, and the specificity was 100%. Conclusion. The presence of LN metastasis and ETE in our PTMC patients in Cyprus is frequent. Neck U/S mapping is a highly reliable and accurate tool in identifying metastatic nodes. LN metastasis is associated with ETE and multifocality. Suspicious subcentimeter nodules should undergo FNA irrespective of size when multifocality is suspected.

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Section: Discussionsupporting

confidence: 93%

Lymph Node Metastasis and Extrathyroidal Extension in Papillary Thyroid Microcarcinoma in Cyprus: Suspicious Subcentimeter Nodules Should Undergo FNA When Multifocality is Suspected

Papaioannou

Lamnisos

Kyriacou³

et al. 2020

Journal of Thyroid Research

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“…Consequently, for patients with cN1 PTC, therapeutic lymph node dissection has been considered the standard treatment ( 36 ). US has been regarded as the most useful tool for diagnosing cervical LNM, and adequate preoperative US detection of regional lymph node is likely to change the surgical planning for patients with thyroid cancer ( 15 , 36 , 37 ). US has high sensitivity and specificity for the diagnosis of lateral LNM, thus providing reliable information to assist in surgical management ( 38 ).…”

Section: Discussionmentioning

confidence: 99%

Thyroid Parenchyma Microcalcifications on Ultrasound for Predicting Lymph Node Metastasis in Papillary Thyroid Carcinoma: A Prospective Multicenter Study in China

Liu

Jia

et al. 2021

Front. Oncol.

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Objective: Cervical lymph node metastasis (LNM) was found to be clinically significant prognostic factors of patients with papillary thyroid carcinomas (PTC). Ultrasound (US) characteristics of thyroid nodules and thyroid parenchyma may be used to predict LNM. To investigate the value of nodular US features as well as thyroid parenchymal microcalcifications on US in predicting LNM in patients with PTC.Methods: This prospective study was approved by the Institutional Review Board. From January 2018 to June 2019, 971 consecutive patients with solitary PTC who underwent preoperative neck US evaluation were included from six hospitals in China. The US features of thyroid nodules as well as thyroid parenchyma microcalcifications were carefully evaluated based on the static images and dynamic clips. Univariate and multivariate analyses were performed to determine independent predictors of LNM.Results: Of the 971 patients, 760 were female, 211 were male. According to the pathological examination, 241(24.82%) patients were found with cervical LNM (LNM positive group), while 730 (75.18%) patients were not (LNM negative group). Multiple logistic regression analysis showed that young age (<55 years old) (OR = 1.522, P = 0.047), large size (>10 mm) (OR = 1.814, P < 0.001), intratumoral microcalcifications (OR = 1.782, P = 0.002) and thyroid parenchyma microcalcifications (OR = 1.635, P = 0.046) were independent risk factors for LNM of PTC.Conclusions: Young age, large nodule size, intratumoral microcalcifications, as well as thyroid parenchyma microcalcifications on US are independent predictors of cervical LNM for patients with PTC.

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“…In experienced hands, high-resolution ultrasonography is the most valuable examination for detecting metastatic lymph nodes in the lateral neck, in both papillary and medullary thyroid carcinoma [23-25]. However, a negative examination does not rule out a possible presence of micrometastases in the lymph nodes.…”

Section: Discussionmentioning

confidence: 99%

“…However, a negative examination does not rule out a possible presence of micrometastases in the lymph nodes. Kocharyan et al [25] found that preoperative ultrasonography of the lateral neck has a 85.4% positive predictive value in detecting metastatic lymph nodes in the lateral neck.…”

Section: Discussionmentioning

confidence: 99%

The Role of Calcitonin in Predicting the Extent of Surgery in Medullary Thyroid Carcinoma: A Nationwide Population-Based Study in Norway

Opsahl¹,

Akslen²,

Schlichting³

et al. 2019

Eur Thyroid J

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Background: Preoperative predictors for the need of prophylactic lymph node dissection in the lateral neck have been studied in patients with medullary thyroid carcinoma (MTC). Objectives: To evaluate the ability of serum calcitonin to predict the extent of surgery needed in the lateral neck. Methods: This retrospective population-based cohort study includes data from 94 of 139 patients with MTC surgically treated in Norway from 2003 to 2016. Patients were identified in the 4 regional centers treating MTC and by the Cancer Registry of Norway, and grouped according to calcitonin levels. In 58 patients without distant metastases or disease progression to the next tumor level (NPNL), data were compared in prognostic groups (N0-NPNL), (N1a-NPNL), and (N1b-NPNL). Results: At calcitonin levels ≤500, 501–1,000, and >1,000 pmol/L, metastatic lymph nodes in the lateral neck were found in 16, 50, and 71% of the patients, respectively. In the prognostic groups, 19% of N0-NPNL patients had calcitonin >500 pmol/L and 17% of N1b-NPNL patients had calcitonin ≤500 pmol/L. In multivariate analysis, factors predicting biochemical cure and calcitonin level ≤500 pmol/L were no metastatic lymph nodes in the lateral neck (p = 0.030) and tumor diameter ≤20 mm (p < 0.001), respectively. Factors related to metastatic lymph nodes in the lateral neck were extrathyroidal extension (p = 0.007) and no biochemical cure (p = 0.028). Conclusions: Basal calcitonin cannot predict the need for prophylactic lateral lymph node dissection in patients with MTC. Further prospective, randomized studies are warranted.

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The relevance of preoperative ultrasound cervical mapping in patients with thyroid cancer

Cited by 10 publications

References 32 publications

Lymph Node Metastasis and Extrathyroidal Extension in Papillary Thyroid Microcarcinoma in Cyprus: Suspicious Subcentimeter Nodules Should Undergo FNA When Multifocality is Suspected

Lymph Node Metastasis and Extrathyroidal Extension in Papillary Thyroid Microcarcinoma in Cyprus: Suspicious Subcentimeter Nodules Should Undergo FNA When Multifocality is Suspected

Thyroid Parenchyma Microcalcifications on Ultrasound for Predicting Lymph Node Metastasis in Papillary Thyroid Carcinoma: A Prospective Multicenter Study in China

The Role of Calcitonin in Predicting the Extent of Surgery in Medullary Thyroid Carcinoma: A Nationwide Population-Based Study in Norway

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