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.

Predictors of sentinel lymph node metastasis in Chinese women with clinical T1-T2 N0 breast cancer and a normal axillary ultrasound

2021 ◽  
pp. 028418512110541
Author(s):  
Fenfen Fu ◽  
Yonghui Zhang ◽  
Jie Sun ◽  
Chun Zhang ◽  
Dongjie Zhang ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Risk Factors ◽  
Lymph Node ◽  
High Risk ◽  
Sentinel Lymph Node ◽  
Regression Model ◽  
Tumor Location ◽  
Axillary Ultrasound ◽  
Outer Quadrant ◽  
High Risk Factors

Background The clinicopathological predictors of sentinel lymph node (SLN) metastasis in clinical T1-T2 N0 (cT1-T2 N0) patients with a normal axillary ultrasound (AUS) are unclear. Purpose To assess the association between clinicopathological characteristics of a primary tumor and SLN metastasis in cT1-T2 N0 patients with a normal AUS. Material and Methods Patients who were diagnosed with cT1-T2 N0 invasive breast cancer and who obtained normal AUS results between October 2016 and September 2018 in a single hospital were included. Clinicopathological data were collected to explore the predictors of SLN metastasis using a multivariate logistic regression model. Results SLN metastasis occurred in 26 patients (18.4%) among 141 AUS-normal patients, of which 24 cases (17.0%) had one or two nodal involvements. In the univariate analysis, tumor location, estrogen receptor (ER) status, progesterone receptor (PR) status, and lymphovascular invasion (LVI) were significantly associated with SLN metastasis ( P < 0.05). The multivariate analysis showed that tumor location in the upper outer quadrant (odds ratio [OR] = 4.49, 95% confidence interval [CI] = 1.63–12.37; P = 0.004), positive PR status (OR = 13.35, 95% CI = 1.60–111.39; P = 0.017), and positive LVI (OR = 8.66, 95% CI = 2.20–34.18; P = 0.002) were independent high-risk factors for SLN metastasis. The area under the receiver operating characteristic curve of the regression model was 0.787 (95% CI = 0.694–0.881; P < 0.001). Conclusion Tumor location in the upper outer quadrant, positive PR, and LVI status were found to be significantly high-risk factors for SLN metastasis among cT1-T2 N0 breast cancer patients with a normal AUS result.

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