Thyroid cancer neck lymph nodes metastasis: Meta-analysis of US and CT diagnosis

Xing, Zhichao; Qiu, Yuxuan; Yang, Qianru; Yu, Yang; Liu, Jingyan; Yuan, Fangyan; Su, Anping; Zhu, Jingqiang

doi:10.1016/j.ejrad.2020.109103

Cited by 56 publications

(42 citation statements)

References 46 publications

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“…Ultrasonography is the first imaging technique in the assessment of cervical lymph nodes metastasis of MTC patients preoperatively. CT exerts an influence on surgical strategy especially for patients with LLNM ( 15 ). It has been reported that ultrasonography has high specificity (85%–97.4%) but low sensitivity (36.7%–61%) in detecting cervical lymph node metastasis in MTC ( 16 , 17 ).…”

Section: Discussionmentioning

confidence: 99%

The Prediction of Metastases of Lateral Cervical Lymph Node in Medullary Thyroid Carcinoma

Zhou

Zhao

et al. 2021

Front. Endocrinol.

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PurposeDevelopment and validation of a nomogram for the prediction of lateral lymph node metastasis (LLNM) in medullary thyroid carcinoma (MTC).MethodsWe retrospectively reviewed the clinical features of patients with MTC in the Surveillance, Epidemiology, and End Results (SEER) database between 2010 and 2017 and in our Department of Surgical Oncology, Hangzhou First People’s Hospital between 2009 and 2019. The log‐rank test was used to compare the difference in the Kaplan–Meier (K–M) curves in recurrence and survival. The nomogram was developed to predict the risk of LLNM in MTC patients. The prediction efficiency of the predictive model was assessed by area under the curve (AUC) and concordance index (C-index) and calibration curves. Decision curve analysis (DCA) was performed to determine the clinic value of the predictive model.ResultA total of 714 patients in the SEER database and 35 patients in our department were enrolled in our study. Patients with LLNM had worse recurrence rate and cancer-specific survival (CSS) compared with patients without LLNM. Five clinical characteristics including sex, tumor size, multifocality, extrathyroidal extension, and distant metastasis were identified to be associated with LLNM in MTC patients, which were used to develop a nomogram. Our prediction model had satisfied discrimination with a C-index of 0.825, supported by both training set and internal testing set with a C-index of 0.825, and 0.816, respectively. DCA was further made to evaluate the clinical utility of this nomogram for predicting LLNM.ConclusionsMale sex, tumor size >38mm, multifocality, extrathyroidal extension, and distant metastasis in MTC patients were significant risk factors for predicting LLNM.

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Section: Discussionmentioning

confidence: 99%

The Prediction of Metastases of Lateral Cervical Lymph Node in Medullary Thyroid Carcinoma

Zhou

Zhao

et al. 2021

Front. Endocrinol.

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“…In this study, the sensitivity of US alone for detection of CCLN metastasis was only 29.5% (79/268), though the specificity was 100% (502/502), which are comparable with previous report ( 15 ). A recent meta-analysis demonstrated that computed tomography performed poorly as US did in identifying the presence of CCLN metastasis ( 31 ). In view of the low efficiency of unimodal imaging, we tried to develop a model incorporating factors of clinicopathology, imaging and gene mutation that could be determined preoperatively to predict the CCLN metastasis.…”

Section: Discussionmentioning

confidence: 99%

Preoperative Prediction of Central Cervical Lymph Node Metastasis in Fine-Needle Aspiration Reporting Suspicious Papillary Thyroid Cancer or Papillary Thyroid Cancer Without Lateral Neck Metastasis

Zhang

Qian²,

Chen³

et al. 2022

Front. Oncol.

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PurposeNo non-invasive method can accurately determine the presence of central cervical lymph node (CCLN) metastasis in papillary thyroid cancer (PTC) until now. This study aimed to investigate factors significantly associated with CCLN metastasis and then develop a model to preoperatively predict CCLN metastasis in fine-needle aspiration (FNA) reporting suspicious papillary thyroid cancer (PTC) or PTC without lateral neck metastasis.Patients and MethodsConsecutive inpatients who were diagnosed as suspicious PTC or PTC in FNA and underwent partial or total thyroidectomy and CCLN dissection between May 1st, 2016 and June 30th, 2018 were included. The total eligible patients were randomly divided into a training set and an internal validation set with the ratio of 7:3. Univariate analysis and multivariate analysis were conducted in the training set to investigate factors associated with CCLN metastasis. The predicting model was built with factors significantly correlated with CCLN metastasis and validated in the validation set.ResultsA total of 770 patients were eligible in this study. Among them, 268 patients had histologically confirmed CCLN metastasis, while the remaining patients did not. Factors including age, BRAF mutation, multifocality, size, and capsule involvement were found to be significantly correlated with the CCLN metastasis in univariate and multivariate analysis. A model used to predict the presence CCLN metastasis based on these factors and US CCLN status yielded AUC, sensitivity, specificity and accuracy of 0.933 (95%CI: 0.905-0.960, p < 0.001), 0.816, 0.966 and 0.914 in the training set and 0.967 (95%CI: 0.943-0.991, p < 0.001), 0.897, 0.959 and 0.936 in the internal validation set.ConclusionAge, BRAF mutation, multifocality, size, and capsule involvement were independent predictors of CCLN metastasis in FNA reporting suspicious PTC or PTC without lateral neck metastasis. A simple model was successfully built and showed excellent discrimination to distinguish patients with or without CCLN metastasis.

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“…Currently, there are many imaging methods for evaluating the status of cervical LN, including ultrasound, CT scan, magnetic resonance imaging (MRI), and positron emission tomography-computed tomography (PET/CT). Ultrasound is usually the first imaging technique in the assessment of cervical LN, but it is operator‐dependent, with the possibility of missing subtle signs [ 37 ]. CT scan examination is a widely applied method for assessing ESCC and cervical LN status [ 38 ].…”

Section: Discussionmentioning

confidence: 99%

Development and validation of a nomogram for prediction of cervical lymph node metastasis in middle and lower thoracic esophageal squamous cell carcinoma

Yan

et al. 2022

BMC Gastroenterol

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Background Estimates of cervical lymph node (LN) metastasis in patients with middle and lower thoracic esophageal squamous cell carcinoma (ESCC) are important. A nomogram is a useful tool for individualized prediction. Methods A total of 235 patients were enrolled in this study. Univariate and multivariate analyses were performed to screen for independent risk factors and construct a nomogram to predict the risk of cervical LN metastasis. The nomogram performance was assessed by discrimination, calibration, and clinical use. Results Totally, four independent predictors, including the maximum diameter of tumor, paraesophageal lymph node status, recurrent laryngeal nerve lymph node status, and the CT-reported cervical LN status, were enrolled in the nomogram. The AUC of the nomogram model in the training and validation dataset were 0.833 (95% CI 0.762–0.905), 0.808 (95% CI 0.696–0.920), respectively. The calibration curve demonstrated a strong consistency between nomogram and clinical findings in predicting cervical LN metastasis. Decision curve analysis demonstrated that the nomogram was clinically useful. Conclusion We developed a nomogram that could be conveniently used to predict the individualized risk of cervical LN metastasis in patients with middle and lower thoracic ESCC.

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Thyroid cancer neck lymph nodes metastasis: Meta-analysis of US and CT diagnosis

Cited by 56 publications

References 46 publications

The Prediction of Metastases of Lateral Cervical Lymph Node in Medullary Thyroid Carcinoma

The Prediction of Metastases of Lateral Cervical Lymph Node in Medullary Thyroid Carcinoma

Preoperative Prediction of Central Cervical Lymph Node Metastasis in Fine-Needle Aspiration Reporting Suspicious Papillary Thyroid Cancer or Papillary Thyroid Cancer Without Lateral Neck Metastasis

Development and validation of a nomogram for prediction of cervical lymph node metastasis in middle and lower thoracic esophageal squamous cell carcinoma

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