Preoperative Nodal US Features for Predicting Recurrence in N1b Papillary Thyroid Carcinoma

This study aimed to investigate whether preoperative ultrasonographic (US) features of metastatic lymph nodes (LNs) are associated with tumor recurrence in patients with N1b papillary thyroid carcinoma (PTC). We enrolled 692 patients (mean age, 41.9 years; range, 6–80 years) who underwent total thyroidectomy and lateral compartment LN dissection between January 2009 and December 2015 and were followed-up for 12 months or longer. Clinicopathologic findings and US features of the index tumor and metastatic LNs in the lateral neck were reviewed. A Kaplan-Meier analysis and Cox proportion hazard model were used to analyze the recurrence-free survival rates and features associated with postoperative recurrence. Thirty-seven (5.3%) patients had developed recurrence at a median follow-up of 66.5 months. On multivariate Cox proportional hazard analysis, male sex (hazard ratio [HR], 2.277; 95% confidence interval [CI]: 1.131, 4.586; p = 0.021), age ≥55 years (HR, 3.216; 95% CI: 1.529, 6.766; p = 0.002), LN size (HR, 1.054; 95% CI: 1.024, 1.085; p < 0.001), and hyperechogenicity of LN (HR, 8.223; 95% CI: 1.689, 40.046; p = 0.009) on US were independently associated with recurrence. Preoperative US features of LNs, including size and hyperechogenicity, may be valuable for predicting recurrence in patients with N1b PTC.

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Review of survival rates 20-years after conservative surgery for papillary thyroid carcinoma

Brazilian Journal of Otorhinolaryngology ◽

10.1016/j.bjorl.2014.08.020 ◽

2015 ◽

Vol 81 (4) ◽

pp. 389-393 ◽

Cited By ~ 3

Author(s):

Abrão Rapoport ◽

Otávio Alberto Curioni ◽

Ali Amar ◽

Rogério Aparecido Dedivitis

Keyword(s):

Papillary Thyroid Carcinoma ◽

Thyroid Carcinoma ◽

Survival Rates ◽

Conservative Surgery ◽

Papillary Thyroid

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Prognosis of Patients with Papillary Thyroid Carcinoma Located in One Lobe Showing Lateral Node Metastasis in the Contralateral but Not Ipsilateral Compartment

Journal of Thyroid Research ◽

10.1155/2012/953603 ◽

2012 ◽

Vol 2012 ◽

pp. 1-4 ◽

Cited By ~ 1

Author(s):

Yasuhiro Ito ◽

Takuya Higashiyama ◽

Yuuki Takamura ◽

Kaoru Kobayashi ◽

Akihiro Miya ◽

...

Keyword(s):

Papillary Thyroid Carcinoma ◽

Thyroid Carcinoma ◽

Lateral Compartment ◽

Carcinoma Cells ◽

Papillary Thyroid ◽

Lateral Node ◽

Node Metastasis ◽

Central Node ◽

Central Node Metastasis ◽

Central Node Dissection

Papillary thyroid carcinoma (PTC) frequently metastasizes to the lymph node in lateral compartment, which can often be detected on preoperative ultrasonography (N1b). However, PTC located in one lobe showing contralateral but not ipsilateral N1b is not common. We analyzed the clinicopathological features and prognosis of 13 patients with PTC limited in one lobe showing contralateral but not ipsilateral N1b. Sizes of the primary lesions ranged from 0.8 cm to 3.0 cm and only 2 tumors showed extrathyroid extension. Metastatic lateral node measured from 0.6 to 3.1 cm. Ten patients showed pathological central node metastasis and 5 had minute PTC lesions in the contralateral lobe. However, 3 patients did not show either of these. None of the patients have developed carcinoma recurrence or died of carcinoma to date. Taken together, PTC located in one lobe with contralateral but not ipsilateral N1b is rare and generally shows an indolent behavior. Although most patients had central node metastasis and/or minute PTC lesions in the contralateral lobe, it is also possible for carcinoma cells to metastasize directly from primary lesions to the contralateral lateral node. Total thyroidectomy with central node dissection and therapeutic MND of the contralateral compartment may be an acceptable surgical design and bilateral MND might not be mandatory.

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Long-term outcomes of follicular variant vs classic papillary thyroid carcinoma

Endocrine Connections ◽

10.1530/ec-18-0264 ◽

2018 ◽

Vol 7 (12) ◽

pp. 1226-1235 ◽

Cited By ~ 5

Author(s):

Lauren E Henke ◽

John D Pfeifer ◽

Thomas J Baranski ◽

Todd DeWees ◽

Perry W Grigsby

Keyword(s):

Papillary Thyroid Carcinoma ◽

Thyroid Carcinoma ◽

Primary Study ◽

Papillary Thyroid ◽

Long Term Outcomes ◽

Follicular Variant ◽

Kaplan Meier ◽

Mutational Status ◽

Clinicopathologic Factors

The majority of papillary thyroid carcinoma (PTC) cases comprise classic papillary (C-PTC) and follicular variant (FV-PTC) histologic sub-types. Historically, clinical equivalency was assumed, but recent data suggest C-PTC may have poorer outcomes. However, large single-institution series with long-term outcomes of C-PTC and FV-PTC, using modern pathologic criteria for FV-PTC, are needed. Our objective was to compare prevalence and impact of clinicopathologic factors, including BRAF mutation status, on long-term outcomes of C-PTC and FV-PTC. We hypothesized that patients with C-PTC would have higher risk disease features and worse survival outcomes. This retrospective study included 1293 patients treated at a single, US academic institution between 1943 and 2009 with mean follow-up of 8.6 years. All patients underwent either partial or total thyroidectomy and had invasive C-PTC or FV-PTC per modern pathology criteria. Primary study measurements included differences in recurrence-free survival (RFS), disease-specific survival (DSS) and associations with clinicopathologic factors including the BRAF mutation. Compared to FV-PTC, C-PTC was associated with multiple features of high-risk disease (P < 0.05) and significantly reduced RFS and DSS. Survival differences were consistent across univariate, multivariate and Kaplan–Meier analyses. BRAF mutations were more common in C-PTC (P = 0.002). However, on Kaplan–Meier analysis, mutational status did not significantly impact RFS or DSS for patients with either histologic sub-type. C-PTC therefore indicates higher-risk disease and predicts for significantly poorer long-term outcomes when compared to FV-PTC. The nature of this difference in outcome is not explained by traditional histopathologic findings or by the BRAF mutation.

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RET/PTC Oncogene Expression in Papillary Thyroid Carcinoma and Its Correlation With Clinicopathologic Findings

The Endocrinologist ◽

10.1097/ten.0b013e318186edfc ◽

2008 ◽

Vol 18 (5) ◽

pp. 233-237

Author(s):

Dilek Arpaci ◽

Ayse Kubat Uzum ◽

Yersu Kapran ◽

Nese Colak Ozbey

Keyword(s):

Papillary Thyroid Carcinoma ◽

Thyroid Carcinoma ◽

Papillary Thyroid ◽

Oncogene Expression ◽

Clinicopathologic Findings

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Clinicopathologic Features and Outcome of the Oncocytic Variant of Papillary Thyroid Carcinoma

Annals of Otology Rhinology & Laryngology ◽

10.1177/000348940911800510 ◽

2009 ◽

Vol 118 (5) ◽

pp. 374-381 ◽

Cited By ~ 10

Author(s):

Menachem Gross ◽

Ron Eliashar ◽

Avraham Ben-Yaakov ◽

Jeffrey M. Weinberger ◽

Bella Maly

Keyword(s):

Papillary Thyroid Carcinoma ◽

Thyroid Carcinoma ◽

Survival Data ◽

Lymph Node Involvement ◽

Outcome Data ◽

Clinicopathologic Features ◽

Papillary Thyroid ◽

Cervical Lymph Nodes ◽

Kaplan Meier ◽

Oncocytic Variant

Objectives: The purpose of this study was to define the clinicopathologic features and outcome of the oncocytic variant of papillary thyroid carcinoma (OVPTC) with a review of the literature. Methods: Twenty-three patients with OVPTC over a 10-year period were studied. Demographic, clinical, and histopathologic features and outcome data were analyzed retrospectively. Results: Seventeen women and 6 men, ages ranging from 20 to 76 years (95% confidence interval, 43.0 to 54.48), were studied. Cervical lymph node involvement was found in 43.4% of the patients. Most of the recurrences were associated with thyroid masses greater than 2 cm in diameter. Evaluation of the overall survival data by the Kaplan-Meier method revealed that most recurrences took place earlier than 30 months, and the majority of patients (74%) were well, with no evidence of disease, up to 78 months after the last treatment. All of the OVPTC cases presented as nonencapsulated tumors, and 78.2% demonstrated extrathyroid stromal invasion. Conclusions: OVPTC is a unique variant of papillary thyroid carcinoma that has distinctive clinicopathologic features. Since OVPTC is often associated with local invasion and may involve cervical lymph nodes, it may require more extensive surgery than classic papillary thyroid carcinoma.

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Prognosis of Patients with Papillary Thyroid Carcinoma Showing Postoperative Recurrence to the Central Neck

World Journal of Surgery ◽

10.1007/s00268-010-0924-3 ◽

2010 ◽

Vol 35 (4) ◽

pp. 767-772 ◽

Cited By ~ 33

Author(s):

Yasuhiro Ito ◽

Takuya Higashiyama ◽

Yuuki Takamura ◽

Kaoru Kobayashi ◽

Akihiro Miya ◽

...

Keyword(s):

Papillary Thyroid Carcinoma ◽

Thyroid Carcinoma ◽

Postoperative Recurrence ◽

Central Neck ◽

Papillary Thyroid

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Ultrasonography-guided Radiofrequency Ablation for Solitary T1aN0M0 and T1bN0M0 Papillary Thyroid Carcinoma: A Retrospective Comparative Study

Acta Endocrinologica ◽

10.1530/eje-21-0580 ◽

2021 ◽

Author(s):

Jing Xiao ◽

Yan Zhang ◽

Lin Yan ◽

Mingbo Zhang ◽

Xinyang Li ◽

...

Keyword(s):

Radiofrequency Ablation ◽

Papillary Thyroid Carcinoma ◽

Thyroid Carcinoma ◽

Tumour Progression ◽

Survival Rates ◽

Recurrent Laryngeal Nerve Injury ◽

Papillary Thyroid ◽

Free Survival ◽

Institutional Review ◽

Retrospective Comparative Study

Objective Ultrasonography-guided radiofrequency ablation (RFA) is used to treat small low-risk papillary thyroid carcinoma (PTC), and has achieved favorable results. However, few studies have compared the outcomes of T1aN0M0 and T1bN0M0 PTC treated with ultrasonography-guided RFA. The objective of this study was to compare the outcomes of patients receiving RFA for solitary T1aN0M0 and T1bN0M0 PTC retrospectively. Methods Patients treated with RFA for solitary T1aN0M0 or T1bN0M0 PTC between April 2014 and December 2019 were retrospectively reviewed. All patients were ineligible for or refused surgery. Our institutional review board approved this study. A total of 262 patients were included after adjustment for propensity score matching between the T1a and T1b groups. Local tumour progression (LTP), LTP-free survival, post-treatment complications, change in tumor volume, and RFA-related parameters were compared between the two groups. Results The LTP rate was 3.82% in both groups, and the LTP and LTP-free survival rates did not significantly differ between the two groups. One patient in group T1b developed transient recurrent laryngeal nerve injury. Significant tumor shrinkage was observed during the follow-up. The rate of tumour disappearance rate was higher in group T1a than in group T1b (81.7% vs. 52.7%, P<0.001). During RFA, the output power and total energy were higher and the duration was significantly shorter in group T1b than in group T1a (P<0.001). Conclusions The outcomes of RFA for the treatment of T1aN0M0 and T1bN0M0 PTC were similar. Therefore, RFA may be an alternative to surgery for the treatment of T1bN0M0 and T1aN0M0 PTCs.

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