WITHDRAWN: The Clinical and Prognosis Value of the Number of Metastatic Lymph Nodes in Papillary Thyroid Carcinoma Patients

Abstract

Objective: It has been reported that papillary thyroid carcinoma (PTC) patients with lymph node metastasis (LNM) are more associated with adverse outcomes. This study aimed to assess the correlation between the lymph node (LN) status and clinical prognosis in PTC patients. Methods: We retrospectively reviewed the medical records of PTC patients who underwent initial thyroid cancer surgery in Renmin Hospital of Wuhan University between 2017 and 2019. 1021 PTC patients with total checked number of lymph nodes ≥5 were involved in this study. The clinicopathological characteristics of patients were compared according to the LN status and the number of metastatic lymph nodes (NMLNs). Results: The LNM and NMLNs>5 were seen in 694 (68.0%) and 222 (21.7%) cases, respectively. Young patients, patients with larger tumor diameter, bilaterality, multifocality and gross extrathyroidal extension (ETE) were more inclined to LNM and NMLNs >5 (P<0.001). The patients with LNM (pN1) were mainly among males and were exhibited multifocality and advanced tumor stage (P<0.001), while pN1 patients with NMLNs >5 were negatively associated with advanced tumour stage (P<0.05). Recurrence-free survival among pN1 patients was significantly different between 2 groups (NMLNs ≤5: 0/472, 100.0%; NMLNs >5: 5/222, 97.7%; P=0.002). In multivariate logistic regression analysis, the male (OR=2.580, P<0.001), 10-mm tumor size (OR=1.770, P<0.001), tumor gross ETE (OR=2.004, P<0.001) were independent predictors for the high prevalence of LNM. Similarly, 10-mm tumor size (OR=1.399, P<0.05), bilaterality (OR=2.350, P<0.001) and tumor gross ETE (OR=2.660, P<0.05) were also independent predictors for the high prevalence of NMLNs >5; 10-year age was an independent predictor for the low prevalence of the LNM (OR=0.658, P<0.001) and NMLNs >5 (OR=0.678, P<0.001). Conclusions: The status of the cervical LNs and the NMLNs should be correctly evaluated to guide reasonable treatment and careful follow-up.