scholarly journals Lymph node metastasis around the entrance point to recurrent laryngeal nerve in papillary thyroid carcinoma

2020 ◽  
Author(s):  
Tian Lv ◽  
Zhuoran Liu ◽  
Jie Kuang ◽  
Jiqi Yan
Keyword(s):  
Lymph Node ◽  
Recurrent Laryngeal Nerve ◽  
Tumor Location ◽  
Nodal Metastasis ◽  
Laryngeal Nerve ◽  
Central Lymph Node ◽  
Tumor Multifocality ◽  
Central Lymph ◽  
Upper Third ◽  
Central Nodal Metastasis

Abstract Background: There were are few reports on the lymph nodes of entrance point to recurrent laryngeal nerve (LN-epRLN) in the patients with papillary thyroid carcinoma (PTC). Therefore,Thus, we investigated the clinical significance of aimed to increase acknowledgement of LN-epRLN and implications it may have.explore clinical implication. Methods: A prospective observational analysis including of 878 consecutive patients with PTC who underwent thyroidectomy from April 2016 to March 2017 was conductedperformed. We explored the surrounding tissue of laryngeal entry pointentrance point to recurrent laryngeal nerve, during routine central lymph node dissection (CLND). The lymph node specimens were sent separately for routine histopathological examination. Thereafter, , and the complications and follow-ups were recorded. Results: LN-epRLNs was were found in 73 of the 878 patients, with and the metastasis metastatic rate of was 3.76%. In univariate analysis, LN-epRLN metastasis was correlated with further central nodal metastasis, tumor location in the upper third of the thyroid and tumor multifocality. Univariate and multivariate analysis showed central lymph node metastases can serve as independent predictors for LN-epRLN metastasis. Conclusions: LN-epRLN can be the site of metastasis of PTC, and the positive LN-epRLN was highly predictive of other central nodal metastasis. LN-epRLN metastases in PTC were also associated with tumor location in the isthmus or upper third of the thyroid and tumor multifocality. In our study, we focus on acknowledgement of LN-epRLN. We emphasized the value of exactitude anatomy and the thoroughness of CLND for cN0-1a PTC.In summary, we confirmed the significance of LN-epRLN in metastasis and recurrence, which required precise anatomy and thorough CLND. In PTC patients, especially in suspicious presence of central cervical lymph node metastasis, attention should be given to excising the nodal tissue at the laryngeal entry point.

scholarly journals Lymph node metastasis around the entrance point to recurrent laryngeal nerve in papillary thyroid carcinoma

2019 ◽  
Author(s):  
Tian Lv ◽  
Zhuoran Liu ◽  
Jie Kuang ◽  
Jiqi Yan
Keyword(s):  
Lymph Node ◽  
Papillary Thyroid Carcinoma ◽  
Recurrent Laryngeal Nerve ◽  
Tumor Location ◽  
Nodal Metastasis ◽  
Laryngeal Nerve ◽  
Papillary Thyroid ◽  
Tumor Multifocality ◽  
Upper Third ◽  
Central Nodal Metastasis

Abstract Background: There were few reports on the lymph nodes of entrance point to recurrent laryngeal nerve (LN-epRLN) in the patients with papillary thyroid carcinoma (PTC). Therefore, we aimed to increase acknowledgement of LN-epRLN and explore clinical implication. Methods: A prospective analysis including 878 consecutive patients with PTC who underwent thyroidectomy from April 2016 to March 2017 was performed. We explored the surrounding tissue of entrance point to recurrent laryngeal nerve, during routine central lymph node dissection (CLND). The lymph node specimens were sent separately for routine histopathological examination, and the complications and follow-ups were recorded. Results: LN-epRLN was found in 73 of the 878 patients and the metastasis rate was 3.76%. In univariate analysis, LN-epRLN metastasis was correlated with further central nodal metastasis, tumor location in the upper third of the thyroid and tumor multifocality. Conclusions: LN-epRLN can be the site of metastasis of PTC, and the positive LN-epRLN was highly predictive of other central nodal metastasis. LN-epRLN metastases in PTC were also associated with tumor location in the isthmus or upper third of the thyroid and tumor multifocality. In our study, we focus on acknowledgement of LN-epRLN. We emphasized the value of exactitude anatomy and the thoroughness of CLND for cN0-1a PTC.

scholarly journals Lymph node metastasis around the entrance point to recurrent laryngeal nerve in papillary thyroid carcinoma

2019 ◽  
Author(s):  
Tian Lv ◽  
Zhuoran Liu ◽  
Jiqi Yan
Keyword(s):  
Lymph Node ◽  
Recurrent Laryngeal Nerve ◽  
Tumor Location ◽  
Nodal Metastasis ◽  
Laryngeal Nerve ◽  
Surrounding Tissue ◽  
Papillary Thyroid ◽  
Tumor Multifocality ◽  
Upper Third ◽  
Central Nodal Metastasis

Abstract Background There were few reports on the lymph nodes of entrance point to recurrent laryngeal nerve (LN-epRLN) in patients with papillary thyroid carcinoma (PTC). Therefore, we aimed to increase awareness of LN-epRLN. Methods A prospective analysis including 878 consecutive patients with PTC who underwent thyroidectomy from April 2016 to March 2017 was performed. We explored the surrounding tissue of entrance point to recurrent laryngeal nerve, during routine central lymph node dissection (CLND). The lymph node specimens were sent separately for routine histopathological examination, and the complications and follow-ups were recorded. Results LN-epRLN was found in 73 of the 878 patients and the metastasis rate was 3.76%. In univariate analysis, LN-epRLN metastasis was correlated with further central nodal metastasis, tumor location in the upper third of the thyroid and tumor multifocality. Conclusions LN-epRLN can be the site of metastasis of PTC. CLND scope should include the surrounding tissue of entrance point to recurrent laryngeal nerve. LN-epRLN metastasis in PTC is associated with tumor location in the isthmus or upper third of the thyroid, tumor multifocality and further central nodal metastasis.

366 CLINICAL NOMOGRAM MODEL FOR RECURRENT LARYNGEAL NERVE LYMPH NODE METASTASIS IN ESOPHAGEAL SQUAMOUS CELL CARCINOMA: A RETROSPECTIVE MULTICENTER STUDY

2020 ◽  
Vol 33 (Supplement_1) ◽  
Author(s):  
D Tian ◽  
X He ◽  
Y Yang ◽  
L Chen
Keyword(s):  
Risk Factors ◽  
Lymph Node ◽  
Recurrent Laryngeal Nerve ◽  
Tumor Size ◽  
Tumor Location ◽  
Laryngeal Nerve ◽  
Tumor Differentiation ◽  
Node Metastasis ◽  
T Stage ◽  
Positive Groups

Abstract   Recurrent laryngeal nerve lymph node metastasis (RLN LNM) is not rare in patients with esophageal cancer. We aimed to explore the risk factors for RLN LNM and to develop a nomogram predicting the likelihood of RLN LNM in esophageal squamous cell carcinoma (ESCC) patients. Methods We retrospectively reviewed patients with ESCC who underwent esophagectomy as well as recurrent laryngeal nerve lymph node dissection between May 2015 and February 2019 at two different institutions. The patients were divided into negative and positive groups according to the presence of RLN LNM. Risk factors for RLN LNM were evaluated by univariate and multivariate analyses. A nomogram was constructed for presentation of the final model. Results A total of 390 patients with ESCC were included in this study. The differences in tumor location, tumor differentiation, T stage, tumor size and carcinoembryonic antigen (CEA) between the negative (N = 270) and positive groups (N = 120) RLN LNM were significant (P < 0.05). Multivariate analysis indicated that the tumor location (OR = 0.520, 95% CI: 0.361–0.749, P < 0.001), tumor differentiation (OR = 2.279, 95% CI: 1.586–3.276, P < 0.001), T stage (OR = 1.436, 95% CI: 1.029–2.003, P = 0.033), tumor size (OR = 1.781, 95% CI: 1.021–3.106, P = 0.042) and CEA (OR = 1.206, 95% CI: 1.003–1.450, P = 0.046) were independent risk factors for RLN LNM. A nomogram with these variables had good predictive accuracy (c-index: 0.716). Conclusion Tumor location, tumor differentiation, T stage, tumor size and CEA may predict the risk of RLN LNM. We created a nomogram predicting the likelihood of RLN LNM in patients with ESCC.

scholarly journals High-risk factors for ipsilateral lateral neck lymph node metastasis in clinically node-negative patients with papillary thyroid microcarcinoma (cT1aN0)

2020 ◽  
Author(s):  
BIN ZHOU ◽  
LIN WEI ◽  
JIANWU QIN
Keyword(s):  
Risk Factors ◽  
Lymph Node ◽  
High Risk ◽  
Tumor Location ◽  
Central Lymph Node ◽  
Neck Lymph Node ◽  
Node Negative ◽  
High Risk Factors ◽  
Thyroid Microcarcinoma ◽  
Central Lymph

Abstract Background: The incidence of papillary thyroid microcarcinoma (PTMC) increases yearly. There are several studies on the high-risk factors for lymph node metastasis in the central compartment of PTMC but few studies on the high-risk factors for lateral neck lymph node (LNLN) metastasis. Few studies have analyzed the high-risk factors for LNLN metastasis for clinically lymph node-negative PTMC patients in stage T1a (cT1aN0). We investigated the risk factors for LNLN metastasis in these patients.Methods: In total, 127 PTMC (cT1aN0) patients underwent hemi- or total thyroidectomy with ipsilateral central lymph node dissection (CLND) plus lateral lymph node dissection (LLND), including levels III and IV, between 2018 and 2019 in our hospital. Univariate and multivariate analyses identified the high-risk factors for LNLN metastasis in PTMC (cT1aN0).Results: The rate of LNLN metastasis was 21.26% (27/127). The multivariate analysis showed that capsular invasion (p=0.027), tumor location at the superior pole (p=0.002) and ipsilateral central lymph node positivity (p=0.001) were independent risk factors for LNLN metastasis in PTMC patients (cT1aN0), with odds ratios (ORs) of 0.181 (95% confidence interval (95% CI): 0.039-0.827), 5.994 (95% CI: 1.949-18.435) and 6.182 (95% CI: 2.193-17.425), respectively.Conclusions: These findings indicate that capsular invasion, tumor location at the superior pole and ipsilateral central lymph node positivity are independent high-risk factors for LNLN metastasis in clinically node-negative PTMC (cT1aN0) patients. High-risk factors should be correctly evaluated to guide surgical treatment for PTMC patients.

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