Metastases to the regional lymph nodes, lymph node recurrence, and distant metastases in nonadvanced papillary thyroid carcinoma

Surgery Today ◽  
1995 ◽  
Vol 25 (4) ◽  
pp. 324-328 ◽  
Author(s):  
Kiminori Sugino ◽  
Yoshio Kure ◽  
Hiroyuki Iwasaki ◽  
Osamu Ozaki ◽  
Takashi Mimura ◽  
...  
2020 ◽  
Author(s):  
Wei Liu ◽  
Zhenglin Wang ◽  
Cong Wang ◽  
Zhilong Ai

Abstract Background: Some studies have reported that Delphian lymph node (DLN) metastasis is associated with a poor prognosis of papillary thyroid carcinoma (PTC), but the number of the available studies is limited and the results are inconsistent. The aim of this investigation was to study the incidence and clinical significance of DLN metastasis in patients with unilateral PTC.Methods: This was a cross-sectional study from January 2016 to December 2019. The data were obtained from the department of general surgery in Shanghai Zhongshan Hospital affiliated to Fudan University. This study included 522 patients with unilateral PTC and had DLN harvested. The associations between DLN metastasis and the clinical characteristics of the patients, i.e. age, sex, tumor size, multifocality, capsular invasion, extrathyroidal extension, central lymph nodes (CLN) metastasis (excluding DLN), and lateral lymph nodes (LLN) metastasis was analyzed.Results: Among all the 522 patients, 133 (25.5%) patients had metastasized DLN lymph nodes. DLN metastasis was significantly associated with age (p = 0.047), male (p < 0.001), larger tumor size (p < 0.001), capsular invasion (p < 0.001), extrathyroidal extension (p = 0.004), tumor location in upper third (p = 0.003), other CLN metastasis (p < 0.001), number of positive CLN (excluding DLN) (p < 0.001), LLN metastasis (p = 0.036), number of positive LLN (p = 0.004) and number of DLN removed (p = 0.043). No association was found between DLN metastasis and multifocality, number of CLN removed and number of LLN removed.Conclusions: DLN metastasis is associated with some adverse prognostic markers of PTC. If the DLN is positive on intraoperative frozen section, careful dissection of CLN and careful evaluation of LLN are essential, and intensive follow-up should be warranted.


2020 ◽  
Author(s):  
Ling Zhan ◽  
Hong-fang Feng ◽  
Xi-zi Yu ◽  
Ling-rui Li ◽  
Jun-long Song ◽  
...  

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.


2016 ◽  
pp. 124-129
Author(s):  
Tran Thuc Huan Nguyen ◽  
Phuong Phung ◽  
Dinh Tung Nguyen ◽  
Viet Dung Nguyen ◽  
Thanh Huy Le

Background: Although lymph-node metastases are common in papillary thyroid cancer, there is considerable debate concerning the use of routine prophylactic lymph-node group VI dissection for all patients undergoing total thyroidectomy. This study was identification the complications and the rate of recurrence of total thyroidectomy plus lymph node group VI dissection in papillary thyroid carcinoma patients. Materials and methods: A prospective study was conducted on 60 patients with papillary thyroid carcinoma. They underwent total thyroidectomy with or without lymph node group VI dissection. Evaluation of postoperative complications and early recurrence rate /distant metastasis after 2 years. Results: The incident of transient hypoparathyroidism in the grouptotal thyroidectomy with or without lymph node group VI dissection respectively 13.3% and 6.7%. Neck lymph node dissection group VI helps detect 40.9% of cases of metastatic lymph nodes clinically undetectable. Neck lymph node recurrence rate in patients with lymph node group VI dissection is lower than group without dissection (3.3% versus 23.3%). Conclusions: Lymph nodes group VIdissection in preventive treatment of papillary thyroid carcinoma should be done. Key words: PTC, lymph-node group VI dissection


Author(s):  
Vanessa Guerreiro ◽  
Cláudia Costa ◽  
Joana Oliveira ◽  
Ana Paula Santos ◽  
Mónica Farinha ◽  
...  

Medullary and papillary thyroid carcinoma are two distinct neoplasms. Its simultaneous is uncommon and its occurrence as a mixed follicular medullary carcinomas is extremely rare. We present a 60-year-old man with the mixed medullary-papillary carcinoma of the thyroid and papillary and medullary component metastases on lymph nodes.


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