scholarly journals Low urinary iodine is a protective factor of central lymph node metastasis in papillary thyroid cancer: a cross-sectional study

2021 ◽  
Vol 19 (1) ◽  
Author(s):  
Ziyang Zeng ◽  
Kang Li ◽  
Xianze Wang ◽  
Siwen Ouyang ◽  
Zimu Zhang ◽  
...  
Keyword(s):  
Thyroid Cancer ◽  
Papillary Thyroid Cancer ◽  
Protective Factor ◽  
Urinary Iodine ◽  
Iodine Intake ◽  
Clinicopathological Features ◽  
Papillary Thyroid ◽  
Central Lymph Node ◽  
High Iodine ◽  
Central Lymph

Abstract Background An abrupt increase of thyroid cancer has been witnessed paralleling the supplemented iodine intake in formerly iodine-deficient countries. And increased iodine intake has been linked to the rising incidence rate of papillary thyroid cancer (PTC). However, the correlation between iodine and clinicopathological features of PTC has not been well-characterized. This study aimed to investigate the associations between iodine intake and the clinicopathological features of PTC patients. Methods Three hundred and fifty-nine PTC patients who received surgical treatment in Peking Union Medical College Hospital from May 2015 to November 2020 were retrospectively reviewed. The associations between urinary iodine (UI), urinary iodine/creatinine ratio (UI/U-Cr), and the clinicopathological features of PTC were analyzed. Univariate and multivariate analysis were performed to investigate the relationship between UI level and central lymph node metastasis (CLNM). Results There were no significant differences in UI in different groups according to the variables studied, except that patients with CLNM had higher UI level than CLNM(−) patients. No associations were found between UI/U-Cr and clinicopathological features except variant subtypes (classic/follicular). After dividing patients into high-iodine group and low-iodine group, more patients were found to have CLNM in the high-iodine group (p = 0.02). In addition, younger age, larger tumor size, and classic variant were positively correlated with CLNM (p < 0.05). Univariate analysis showed that insufficient iodine intake (≤ 99 μg/L) was associated with decreased CLNM risk in PTC. And after defining insufficient iodine intake as ≤ 109 μg/L and above requirements as ≥ 190 μg/L, multivariate analysis showed that lower iodine was associated with CLNM in total population of PTC (OR 0.53, 95% CI 0.31–0.91) and in PTC < 1 cm (papillary thyroid microcarcinoma, PTMC) (OR 0.43, 95% CI 0.21–0.87). Conclusions Low iodine was a protective factor for CLNM in papillary thyroid cancer, particularly in those < 1 cm. These results indicated that iodine may not only be an initiator of tumorigenesis, but also a promoter of the development of PTC.

Low Urinary Iodine is a Protective Factor of Central Lymph Node Metastasis in Papillary Thyroid Cancer: A Cross-sectional Study

2021 ◽  
Author(s):  
Ziyang Zeng ◽  
Kang Li ◽  
Xianze Wang ◽  
Siwen Ouyang ◽  
Zimu Zhang ◽  
...  
Keyword(s):  
Thyroid Cancer ◽  
Papillary Thyroid Cancer ◽  
Protective Factor ◽  
Urinary Iodine ◽  
Iodine Intake ◽  
Clinicopathological Features ◽  
Papillary Thyroid ◽  
Central Lymph Node ◽  
High Iodine ◽  
Central Lymph

Abstract Background: An abrupt increase of thyroid cancer has been witnessed paralleling the supplemented iodine intake in formerly iodine-deficient countries. And increased iodine intake has been linked to the rising incidence rate of papillary thyroid cancer (PTC). However, the correlation between iodine and clinicopathological features of PTC has not been well-characterized. This study aimed to investigate the associations between iodine intake and the clinicopathological features of PTC patients.Methods: 359 PTC patients who have received surgical treatment in Peking Union Medical College Hospital from May 2015 to November 2020 were retrospectively reviewed. The associations between urinary iodine (UI), urinary iodine/creatinine ratio (UI/U-Cr) and the clinicopathological features of PTC were analyzed. Univariate and multivariate analysis were performed to investigate the relationship between UI level and central lymph node metastasis (CLNM).Results: There were no significant differences of UI in different groups according to the variables studied, except that patients with CLNM had higher UI level than CLNM(-) patients. No associations were found between UI/U-Cr and clinicopathological features except variant subtypes (classic/follicular). After dividing patients into high-iodine group and low-iodine group, more patients were found to have CLNM in high-iodine group (p=0.017). In addition, younger age, larger tumor size and classic variant positively correlated with CLNM (p<0.05). Univariate analysis showed that insufficient iodine intake (≤ 99 μg/L) were associated with decreased CLNM risk in PTC. And after defining insufficient iodine intake as ≤ 109 μg/L and above requirements as ≥ 190 μg/L, multivariate analysis showed that lower iodine was associated with CLNM in total population of PTC (OR: 0.53, 95 % CI: 0.31 - 0.91) and in PTC < 1cm (papillary thyroid microcarcinoma, PTMC) (OR: 0.43, 95 % CI: 0.21 - 0.87).Conclusions: Low iodine was a protective factor for CLNM in papillary thyroid cancer, particularly in those < 1 cm. These results indicated that iodine may not only be an initiator of tumorigenesis, but also a promoter of the development of PTC.

Multifocal Papillary Thyroid Cancer Increases the Risk of Central Lymph Node Metastasis

Thyroid ◽  
2015 ◽  
Vol 25 (9) ◽  
pp. 1008-1012 ◽  
Author(s):  
Ayham Al Afif ◽  
Blair A. Williams ◽  
Mathew H. Rigby ◽  
Martin J. Bullock ◽  
S. Mark Taylor ◽  
...  
Keyword(s):  
Thyroid Cancer ◽  
Lymph Node ◽  
Lymph Node Metastasis ◽  
Papillary Thyroid Cancer ◽  
Papillary Thyroid ◽  
Central Lymph Node Metastasis ◽  
Central Lymph Node ◽  
Node Metastasis ◽  
Central Lymph

scholarly journals 2314 (In)Adequacy of prophylactic central lymph node dissection for papillary thyroid cancer in the United States: An analysis of 18,755 patients

2018 ◽  
Vol 2 (S1) ◽  
pp. 77-77
Author(s):  
Keven Seung Yong Ji ◽  
Taofik Oyekunle ◽  
Julie A. Sosa ◽  
Sanziana A. Roman
Keyword(s):  
Thyroid Cancer ◽  
Lymph Node ◽  
Papillary Thyroid Cancer ◽  
Papillary Thyroid ◽  
Node Dissection ◽  
Central Lymph Node ◽  
Central Lymph Node Dissection ◽  
Disease Characteristics ◽  
Central Lymph ◽  
To Receive

OBJECTIVES/SPECIFIC AIMS: The incidence of papillary thyroid cancer (PTC) has sharply increased in recent decades. Though thyroid resection is the best treatment modality, there is significant variation in practice involving use of prophylactic central lymph node dissection (PCLND) at time of thyroidectomy. Recently, a threshold number for lymph node (LN) yield was determined to assure adequacy of lymphadenectomy in evaluating occult nodal disease via PCLND for pathologic T3, clinical N0, M0 PTC patients, for whom guidelines recommend PCLND. This study assesses the prevalence of adequate prophylactic LN dissection (APLND) and determines its association with patient, and disease characteristics. METHODS/STUDY POPULATION: Adult patients receiving surgery for pT3 cN0 M0 PTC >1 cm were identified from the National Cancer Data Base, 2004–2015. APLND for pT3 stage was defined as removing 8 or more LNs, based on recent literature. Univariate and multivariate logistic regression models were employed to determine factors associated with APLND and inadequate prophylactic LN dissection (IPLND). RESULTS/ANTICIPATED RESULTS: In total, 18,755 patients were included: 2905 (10.1%) had APLND; 15,849 (89.9%) had IPLND. Rate of APLND increased from 4.9% to 17.9% over the decade. Patients receiving APLND were younger than those receiving IPLND (47 vs. 52 years, respectively, p<0.001). The proportion of cases found to be LN positive in the APLND group was 64.5%, while that in the IPLND group was 18.2% (p<0.001). After adjustment, Whites were more likely than Blacks to receive APLND [OR 1.86 (95% CI 1.51–2.30), p<0.001]. The adjusted OR of receiving APLND was higher at academic centers [1.76 (1.29–2.41), p<0.001] and at integrated centers [1.77 (1.25–2.51), p<0.001], compared with community facilities. After adjustment, patients with multifocal tumors were more likely to receive APLND than those with unifocal tumors [1.28 (1.17–1.41), p<0.001]. Unplanned 30-day readmission rate was higher in the APLND group (2.4%) compared to the IPLND group (1.7%, p<0.001); this remained significant after adjustment [OR for APLND 1.80 (1.31–2.47), p<0.001]. There was no significant difference in the likelihood of receiving radioactive iodine between patients who underwent APLND Versus IPLND [1.00 (0.90–1.00), p=0.6]. DISCUSSION/SIGNIFICANCE OF IMPACT: APLND is associated with a higher likelihood of finding metastatic LNs, and an increased risk of unplanned short-term readmissions. The rate of APLND has increased over time, but still only a minority of thyroid cancer patients undergo adequate prophylactic surgery. Disparities exist based on patient, facility, and disease characteristics. Further work is needed to study the association between adequacy of dissection and disease recurrence.

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