scholarly journals Clinicopathological and Ultrasound Features as Risk Stratification Predictors of Clinical and Pathological Nodal Status in Papillary Thyroid Carcinoma: A Study of 748 Patients

2021 ◽  
Author(s):  
Cui ZHANG ◽  
Baojun LI ◽  
LEI ZHANG ◽  
Fengjiao CHEN ◽  
Yanhua ZHANG ◽  
...  
Keyword(s):  
Risk Factors ◽  
Lymph Node ◽  
Papillary Thyroid Carcinoma ◽  
Tumor Size ◽  
Primary Tumor ◽  
Intermediate Risk ◽  
Papillary Thyroid ◽  
Primary Tumor Size ◽  
Independent Risk Factors ◽  
Ultrasound Features

Abstract Background: Papillary thyroid carcinoma (PTC) is the most common histological type of thyroid malignancy that tends to metastasize to cervical lymph nodes. In the present study, we aimed to investigate which clinicopathologic and ultrasound features of PTC are associated with clinical lymph node metastasis (LNM) and numbers of pathological LNM.Methods: From January 2016 to December 2018, we identified a cohort of patients with PTC who underwent cervical ultrasonography and were diagnosed through operation and pathology. Clinical N1(cN1) and >5 pathologic N1(pN1) was performed in accordance with a standardized protocol. A model to determine the intermediate risk stratification of the 2015 ATA was established using the outcomes of univariate and multivariate analyses. Results: we collected 748 PTC patients in the final inclusion criteria. From the analyses, primary tumor size >21mm, capsule contact, extrathyroidal extensions (ETE), postsurgical radioiodine (RAI) treatment and central LNM remained independent risk factors for cN1 in PTC patients. Multifocality, primary tumor size >21mm, capsule contact, ETE and RAI treatment are significant independent risk factors for >5 pN1. Primary tumor size >21mm, capsule contact, ETE and RAI treatment were independent risk factors for both cN1 and >5 pN1.Conclusions: We conclude that primary tumor size >21mm, capsule contact, ETE and RAI treatment were independent predictors of for intermediate risk of recurrence in patients with PTC. Ultrasonography is a good technique for the preoperative lymph node staging of PTC and is helpful for detecting LNM.

scholarly journals A Study on Central Lymph Node Metastasis in 543 cN0 Papillary Thyroid Carcinoma Patients

2016 ◽  
Vol 2016 ◽  
pp. 1-5 ◽  
Author(s):  
Huanhuan Yan ◽  
Xiaoqian Zhou ◽  
Hui Jin ◽  
Xiang Li ◽  
Miao Zheng ◽  
...  
Keyword(s):  
Risk Factors ◽  
Multivariate Analysis ◽  
Lymph Node ◽  
Papillary Thyroid Carcinoma ◽  
Tumor Size ◽  
Male Gender ◽  
Papillary Thyroid ◽  
Central Lymph Node ◽  
Node Metastasis ◽  
Central Lymph

Background. Papillary thyroid carcinoma (PTC) with central lymph node metastases (CLNMs) is common. The objective of this study was to investigate the incidence and risk factors of lymph node metastasis patients with PTC.Patients and Methods. Between January 2013 and February 2015, a retrospective study of 543 patients with PTC undergoing hemithyroidectomy or total thyroidectomy with routine central lymph node dissection (CLND) was analyzed. Clinicopathologic risk factors for CLNM were studied using univariate and multivariate analysis by SPSS 22.0 software.Results. The incidence of CLNMs in PTC patients was 38.1% (207/543). In the multivariate analysis, male gender (p<0.001, OR: 1.984), age <45 years (p<0.001, OR: 1.934), bilaterality (p=0.006, OR: 1.585), tumor size ≥0.25 cm (p=0.001, OR: 7.655), and external extension (p=0.001, OR: 7.579) were independent risk factors of CLNMs. Furthermore, in PTC patients with tumor size <0.25 cm, all 7 males and 21 patients with unilaterality were not found to have CLNMs.Conclusions. CLNMs are prevalent in the PTC patients with the following risk factors: male gender, age <45 years, bilaterality, tumor size ≥0.25 cm, and external extension. PTC patients with tumor size <0.25 cm, male patients, and patients with unilateral lesion could be considered safe from CLNMs.

scholarly journals Comparison of ultrasonography and CT for preoperative nodal assessment of patients with papillary thyroid cancer: diagnostic performance according to primary tumor size

2019 ◽  
Vol 61 (1) ◽  
pp. 21-27 ◽  
Author(s):  
So Yeon Yang ◽  
Jung Hee Shin ◽  
Soo Yeon Hahn ◽  
Yaeji Lim ◽  
Seok Young Hwang ◽  
...  
Keyword(s):  
Thyroid Cancer ◽  
Lymph Node ◽  
Tumor Size ◽  
Primary Tumor ◽  
Preoperative Evaluation ◽  
Papillary Thyroid ◽  
Primary Tumor Size ◽  
Tertiary Referral Center ◽  
Lower Accuracy ◽  
Sensitivity Specificity

Background Indications for computed tomography (CT) in preoperative patients with thyroid cancer are still controversial. Purpose To determine the value of CT and ultrasonography (US) in preoperative lymph node assessment of patients with papillary thyroid carcinoma (PTC) according to primary tumor size. Material and Methods A total 453 patients with surgically proven PTC who underwent US and CT for preoperative evaluation in 2010 at our tertiary referral center were included. The diagnostic sensitivity, specificity, and accuracy of US, CT, and the combination of US and CT (US/CT) in the preoperative nodal assessment were compared. We performed subgroup analysis to compare the findings according to primary tumor size. Results In overall tumors, adding CT to US had greater sensitivity, lower specificity, and greater accuracy in predicting central lymph node metastasis (LNM) but lower accuracy in prediction of lateral LNM. In smaller cancers (≤1 cm), US alone had greater specificity and accuracy than CT alone or US/CT in predicting lateral LNM. In larger cancers (>1 cm), CT had greater sensitivity and accuracy than US in predicting central LNM, while US had greater specificity and accuracy than CT in predicting lateral LNM. There were no patients with smaller tumors who showed retropharyngeal and superior mediastinal LNM diagnosed by CT alone. Conclusion CT is superior to US for detecting central LNM in preoperative patients with PTCs > 1 cm. However, there are no benefits to adding CT to US to predict lateral LNM in small cancers (≤1 cm).

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