Risk factors analyses for lateral lymph node metastases in papillary thyroid carcinomas: a retrospective study of 356 patients

BackgroundPapillary thyroid micro-carcinoma (PTMC) is defined as a tumor with a larger diameter ≤1 cm which has an indolent course and satisfying prognosis. However, the incidence of lymph node metastasis of PTMC cannot be ignored. The aim of this study was to assess the incidence of lymph node metastasis in PTMC patients, as well as to evaluate the risk factors for both central lymph node metastases (CLNM) and lateral lymph node metastases (LLNM).MethodsPatients who underwent thyroidectomy from January 2017 to October 2020, and pathologically diagnosed with PTMC were enrolled in our study and their medical records were collected and analyzed.ResultsA total of 484 PTMC patients were included. The incidence of central and lateral lymph node metastasis was 49.6% and 9.1%, respectively. Multivariate analysis demonstrated as independent risk factors for CLNM male sex, age <40 years, largest tumor size ≥5 mm and bilaterality. Extrathyroidal extension, presence of CLNM, number of CLNM ≥5 were strong indicators for LLNM.ConclusionThe incidence of lymph node metastases in PTMC is non-negligible. The identification of potential risk factors for CLNM and LLNM would help tailor individual surgical interventions for patients with PTMC.

Download Full-text

Allele Percentage of theBRAFV600E Mutation in Papillary Thyroid Carcinomas and Corresponding Lymph Node Metastases: No Evidence for a Role in Tumor Progression

The Journal of Clinical Endocrinology & Metabolism ◽

10.1210/jc.2012-3930 ◽

2013 ◽

Vol 98 (5) ◽

pp. E934-E942 ◽

Cited By ~ 39

Author(s):

Greta Gandolfi ◽

Valentina Sancisi ◽

Federica Torricelli ◽

Moira Ragazzi ◽

Andrea Frasoldati ◽

...

Keyword(s):

Lymph Node ◽

Tumor Progression ◽

Lymph Node Metastases ◽

Papillary Thyroid ◽

Thyroid Carcinomas ◽

Node Metastases

Download Full-text

Multifocal Papillary Thyroid Carcinoma，Hashimoto's Thyroiditis and Lymph Node Metastasis：A Retrospective Cohort Study

10.21203/rs.3.rs-194311/v1 ◽

2021 ◽

Author(s):

Denghui Wang ◽

Jiang Zhu ◽

Chang Deng ◽

Zhixin Yang ◽

Daixing Hu ◽

...

Keyword(s):

Risk Factors ◽

Lymph Node ◽

Lymph Node Metastases ◽

Protective Factor ◽

Roc Curves ◽

Multivariate Logistic Regression ◽

Lateral Lymph Node ◽

Node Metastases ◽

Independent Risk Factors ◽

Central Lymph

Abstract Objective: Few studies have evaluated the influence of HT and Multifocality on central lymph node metastases(CLNM) and lateral lymph node metastases(LLNM) of PTC. The present study focused on risk factors for lymph node metastasis in PTC according to the presence of HT or multifocality. Materials and methods:1413 patients were identified.The relationship between HT or multifocality and lymph nodemetastasis was analyzed by univariate and multivariate logistic regression, ROC curves were constructed to show the predictive effect of each variable on the target outcome.Results: The PTCs with HT were more likely to be multifocal.(40.0% versus 17.5%,P ＜0.001). Compared to MPTC without HT, MPTC with HT showed a lower number of metastatic CLNs and LLNs (P < 0.05). HT was identifified as an independent protective factor for CLNM in all PTC patients (OR, 0.480; 95% CI, 0.359-0.643; P< .001) and in MPTC patients (OR, 0.094; 95% CI, 0.044-0.204; P < 0.001), the multicocality was independent risk factors for CLNM(OR, 2.316; 95% CI, 1.667-3.217; P< 0.001) and LLNM(OR, 2.004; 95% CI, 1.469-2.733; P< 0.001).The variables concluded HT or MPTC were screened to predict CLNM in all patients, CLNM in patients with MPTC and LLNM in all patients (AUCs: 0.731, 0.843 and 0.696, respectively, P < 0.0001). The two type of diseases existed concurrently may result in the decrease of CLNM and LLNM, AUCs of ROC to predict CLNM and LLNM are 0.696 and 0.63(P<0.0001). Conclusions: Our study identified multifocality as an independent risk factor predicting CLNM and LLNM in PTC patients. HT was proven to be a protective factor that reduced the CLNM risk in all patients and in patients with MPTC. The existence of both type of diseases can result in the reduction of CLNM and LLNM.

Download Full-text

A rare germline mutation c.2752 A>G (p.M918V) in the RET protooncogene in a patient with medullary and papillary thyroid carcinomas in cervical lymph node metastases: a case report and review of the literature

Clinical and experimental thyroidology ◽

10.14341/ket2016146-52 ◽

2016 ◽

Vol 12 (1) ◽

pp. 46

Author(s):

Faina A. Amosenko ◽

Vladimir V. Khvostovoy ◽

Olga A. Shchagina ◽

Alexandr V. Polyakov

Keyword(s):

Case Report ◽

Lymph Node ◽

Germline Mutation ◽

Lymph Node Metastases ◽

Cervical Lymph Node ◽

Papillary Thyroid ◽

Review Of The Literature ◽

Cervical Lymph Node Metastases ◽

Thyroid Carcinomas ◽

Node Metastases

Download Full-text

The Surgical Management of Papillary Thyroid Microcarcinoma: A 162-Month Single-Center Experience of 273 Cases

The American Surgeon ◽

10.1177/000313481207801127 ◽

2012 ◽

Vol 78 (11) ◽

pp. 1215-1218 ◽

Cited By ~ 5

Author(s):

Qingqing He ◽

Dayong Zhuang ◽

Luming Zheng ◽

Ziyi Fan ◽

Peng Zhou ◽

...

Keyword(s):

Risk Factors ◽

Lymph Node ◽

Surgical Management ◽

Lymph Node Metastases ◽

Papillary Thyroid Microcarcinoma ◽

Papillary Thyroid ◽

Neck Lymph Node ◽

Lateral Node ◽

Thyroid Microcarcinoma ◽

Node Metastases

The aim of this study was to evaluate outcomes for patients with papillary thyroid microcarcinoma (PTMC) treated at a single institution during a 162-month period and to determine which patients need aggressive treatment. Two hundred seventy-three patients with PTMC had subtotal or total thyroidectomy 1 prophylactic or therapeutic lymph node dissection. Clinical and histopathological characteristics of 273 patients were identified and statistically analyzed. The tumors were multifocal in 36.3 per cent of the patients with PTMCs. Fifty-six per cent had neck lymph node metastases at diagnosis. Large-sized tumor (over 5 mm), age older than 45 years, multifocality, bilaterality, and extrathyroidal extension were associated with subclinical central lymph node metastases. Ninety-six patients older than 45 years of age were upgraded from Stage I to III or IVA. Ten patients with lateral node recurrence or local recurrence in the residual thyroid had one or more risk factors. The high rates of multifocality and Level VI area subclinical lymph node metastasis were two important clinical and histopathological characteristics of PTMC. Patients who had one or more risk factors should receive more aggressive surgical management.

Download Full-text

Risk Factors and a Prediction Model of Lateral Lymph Node Metastasis in CN0 Papillary Thyroid Carcinoma Patients With 1–2 Central Lymph Node Metastases

Frontiers in Endocrinology ◽

10.3389/fendo.2021.716728 ◽

2021 ◽

Vol 12 ◽

Author(s):

Yuanyuan Wang ◽

Chang Deng ◽

Xiujie Shu ◽

Ping Yu ◽

Huaqiang Wang ◽

...

Keyword(s):

Risk Factors ◽

Lymph Node ◽

Lymph Node Metastasis ◽

Lateral Lymph Node Metastasis ◽

Papillary Thyroid ◽

Central Lymph Node ◽

Lateral Lymph Node ◽

Node Metastasis ◽

Node Metastases ◽

Central Lymph

BackgroundPapillary thyroid cancer (PTC) in clinically lymph node-negative (cN0) patients is prone toward lymph node metastasis. As a risk factor for tumor persistence and local recurrence, lateral lymph node metastasis (LLNM) is related to the number of central lymph node metastases (CLNMs).MethodsWe performed LLNM risk stratification based on the number of CLNMs for cN0 PTC patients who underwent thyroidectomy and lymph node dissection between January 2013 and December 2018. A retrospective analysis was applied to the 274 collected patients with 1-2 CLNMs. We examined the clinicopathological characteristics of the patients and constructed a LASSO model.ResultsIn the 1–2 CLNM group, tumors >10 mm located in the upper region and nodular goiters were independent risk factors for LLNM. Specifically, tumors >20 mm and located in the upper region contributed to metastasis risk at level II. Hashimoto’s thyroiditis reduced this risk (p = 0.045, OR = 0.280). Age ≤ 30 years and calcification (microcalcification within thyroid nodules) correlated with LLNM. The LASSO model divided the population into low- (25.74%) and high-risk (57.25%) groups for LLNM, with an AUC of 0.715.ConclusionsFor patients with 1–2 CLNMs, young age, calcification, nodular goiter, tumor >10 mm, and tumor in the upper region should alert clinicians to considering a higher occult LLNM burden. Close follow-up and therapy adjustment may be warranted for high-risk patients.

Download Full-text