scholarly journals Predictors of Central Compartment Involvement in Patients with Positive Lateral Cervical Lymph Nodes according to Clinical and/or Ultrasound Evaluation

2021 ◽  
Vol 10 (15) ◽  
pp. 3407
Author(s):  
Giuseppa Graceffa ◽  
Giuseppina Orlando ◽  
Gianfranco Cocorullo ◽  
Sergio Mazzola ◽  
Irene Vitale ◽  
...  
Keyword(s):  
Lymph Nodes ◽  
Univariate Analysis ◽  
Roc Curves ◽  
Central Compartment ◽  
Central Neck Dissection ◽  
Level Of Evidence ◽  
Cervical Lymph Nodes ◽  
Kaplan Meier ◽  
Ultrasound Evaluation ◽  
Central Lymph

Lymph node neck metastases are frequent in papillary thyroid carcinoma (PTC). Current guidelines state, on a weak level of evidence, that level VI dissection is mandatory in the presence of latero-cervical metastases. The aim of our study is to evaluate predictive factors for the absence of level VI involvement despite the presence of metastases to the lateral cervical stations in PTC. Eighty-eight patients operated for PTC with level II–V metastases were retrospectively enrolled in the study. Demographics, thyroid function, autoimmunity, nodule size and site, cancer variant, multifocality, Bethesda and EU-TIRADS, number of central and lateral lymph nodes removed, number of positive lymph nodes and outcome were recorded. At univariate analysis, PTC location and number of positive lateral lymph nodes were risk criteria for failure to cure. ROC curves demonstrated the association of the number of positive lateral lymph nodes and failure to cure. On multivariate analysis, the protective factors were PTC located in lobe center and number of positive lateral lymph nodes < 4. Kaplan–Meier curves confirmed the absence of central lymph nodes as a positive prognostic factor. In the selected cases, Central Neck Dissection (CND) could be avoided even in the presence of positive Lateralcervical Lymph Nodes (LLN+).

Morbidity associated to advanced gastric cancer and its impact on overall survival.

2020 ◽  
Vol 38 (4_suppl) ◽  
pp. 327-327
Author(s):  
Mónica Isabel Meneses Medina ◽  
Ana Karen Valenzuela ◽  
Jorge Humberto Hernandez-Felix ◽  
Haydee Cristina Verduzco-Aguirre ◽  
Vanessa Rosas Camargo ◽  
...  
Keyword(s):  
Gastric Cancer ◽  
Lymph Nodes ◽  
Advanced Gastric Cancer ◽  
Univariate Analysis ◽  
Rank Test ◽  
P Value ◽  
High Morbidity ◽  
Regional Lymph Nodes ◽  
Oncological Treatment ◽  
Kaplan Meier

327 Background: Advanced gastric cancer (GC) is a disease with high morbidity and poor prognosis. We hypothesize that different sites of metastasis have different impact in terms of symptoms and complications. We sought to evaluate if site specific morbidity in our patients impacted treatment and survival. Methods: Medical records from patients with advanced GC treated from Jan 2005 to Dec 2015 were retrospectively reviewed. Morbidity was defined as having any symptom by metastases in a specific site. OS was estimated by Kaplan Meier method and compared by Log-rank test. P value < 0.05 was considered significant. Results: We included 180 consecutive patients, median age at diagnosis was 56 years (21-90), 55% were women. Most common sites of metastases were: peritoneum 76.1%, non-regional lymph nodes 38.9%, liver 22.8%, lung 26.7%, bone 9.4% and ovary 12.8%. Regarding morbidity, at diagnosis 68% of patients presented morbidity by the primary tumor: obstruction 56%, bleeding 27%, obstruction and bleeding 3%, other 14%. Disease by peritoneum caused morbidity in 30%, by lung in 8%, by ovarian in 4.4%, by lymph nodes in 3.3%, and by other sites in 5.6% of patients. OS in the global cohort was: 3.53 months (2.2 to 4.8), nevertheless by univariate analysis we found that OS was affected by morbidity at some sites as it is show in table. More patients with peritoneal morbidity could not receive treatment vs those without peritoneal morbidity (p = 0.042). Conclusions: We found that morbidity in peritoneum, lung and ovary adversely affected prognosis of patients with advanced GC. Moreover, peritoneal morbidity preclude patients from receiving oncological treatment. [Table: see text]

scholarly journals The Number of Central Lymph Nodes on Preoperative Ultrasound Predicts Central Neck Lymph Node Metastasis in Papillary Thyroid Carcinoma: A Prospective Cohort Study

2020 ◽  
Vol 2020 ◽  
pp. 1-6
Author(s):  
Luying Gao ◽  
Juanjuan Wang ◽  
Yuxin Jiang ◽  
Qiong Gao ◽  
Ying Wang ◽  
...  
Keyword(s):  
Lymph Nodes ◽  
Area Under The Curve ◽  
Central Compartment ◽  
Central Neck ◽  
Papillary Thyroid ◽  
Neck Lymph Node ◽  
Node Metastasis ◽  
Neck Lymph Node Metastasis ◽  
Central Lymph ◽  
Sensitivity Specificity

To evaluate the effectiveness of the number of central compartment lymph nodes (CLNs) on ultrasound (US) in predicting CLN metastasis (CLNM). We prospectively studied 309 papillary thyroid cancer (PTC) patients who underwent thyroidectomy with CLN dissection at our center from May 2017 to July 2017. The number and features of CLNs were evaluated preoperatively via US. All US examinations were performed using a Philips iU 22 or a GE Logiq 9 machine. Correlations between CLNs observed via preoperative US and amount of CLNM were evaluated. We found that ≥2 CLNs on the preoperative US was associated with CLNM (P<0.01). For this feature, the sensitivity, specificity, and area under the curve (AUC) were 54.3%, 66.1%, and 0.61, respectively. The presence of both suspected metastasis and ≥2 CLNs on US had a specificity of 86.5%. In addition, ≥3 CLNs on preoperative US was associated with large-volume CLNM (>5 metastatic CLNs) (P<0.01). For this feature, the sensitivity, specificity and AUC were 54.8%, 74.5% and 0.65, respectively. The presence of both suspected metastasis and ≥3 CLNs on US had a specificity of 84.9%. The presence of suspected metastasis and/or ≥3 CLNs had a sensitivity of 80.6%. Our results suggest that ≥2 and ≥ 3 CLNs on preoperative US may serve as ancillary preoperative markers for predicting CLNM.

scholarly journals Risk factors for central lymph node metastasis in the cervical region in papillary thyroid carcinoma: a retrospective study

2021 ◽  
Vol 19 (1) ◽  
Author(s):  
Xiang Li ◽  
Hanwen Zhang ◽  
Yu Zhou ◽  
Ruochuan Cheng
Keyword(s):  
Risk Factors ◽  
Lymph Node ◽  
Lymph Nodes ◽  
Vascular Invasion ◽  
Univariate Analysis ◽  
Multivariable Analysis ◽  
Cervical Region ◽  
Tumor Diameter ◽  
Central Lymph Node ◽  
Central Lymph

Abstract Background To investigate the influence of different risk factors on central lymph node metastasis (CLNM) in the cervical region in patients with papillary thyroid carcinoma (PTC). Methods This retrospective study included 2586 PTC patients. Potential risk factors were identified by univariate analysis, and the relationships between these factors and CLNM were ascertained by multivariable analysis. A scoring system was constructed, and the optimal cut-off value was determined. Results On univariate analysis, sex, age, tumor diameter, multifocality, capsule invasion, vascular invasion, total number of lymph nodes in the central region, and serum thyroid peroxidase antibody (TPOAb) concentration were identified as potential risk factors for CLNM in the cervical region, whereas nerve invasion, thyroid-stimulating hormone concentration, and thyroglobulin antibody (TgAb) concentration were not. Multivariable analysis indicated that male sex, young age, large tumor diameter, multifocality, vascular invasion, a large number of central lymph nodes, and a low TPOAb concentration were significant risk factors. From these factors, a preoperative CLNM risk assessment scale was constructed for predicting CLNM in the cervical region for PTC patients. Conclusion Male sex, young age, large tumor diameter, multifocality, vascular invasion, a large number of central lymph nodes, and a low TPOAb concentration were positively correlated with CLNM in the cervical region in PTC patients. The preoperative CLNM risk assessment scale based on these risk factors is expected to offer accurate preoperative assessment of central lymph node status in PTC patients.

scholarly journals Benign-Appearing Thyroid Follicles in Cervical Lymph Nodes: A Report of 3 Cases and a Review of the Literature

2018 ◽  
Vol 103 (5-6) ◽  
pp. 255-259
Author(s):  
Peiyou Ren ◽  
Su Dong ◽  
Meishan Jin ◽  
Guang Chen ◽  
Jia Liu
Keyword(s):  
Lymph Nodes ◽  
Thyroid Tissue ◽  
Nodular Goiter ◽  
Central Neck Dissection ◽  
Cervical Lymph Nodes ◽  
Thyroid Glands ◽  
Thyroid Papillary ◽  
Disease Free ◽  
Benign Thyroid

Thyroid carcinoma tissue is frequently found in cervical lymph nodes following metastasis of thyroid, and particularly, thyroid papillary carcinoma. However, thyroid follicles without any malignant characteristics also are frequently detected in cervical lymph nodes. The reasons for the existence of “benign thyroid tissue” in lymph nodes are presently not understood. We present 3 cases of benign-appearing thyroid follicles in cervical lymph nodes. All patients underwent thyroidectomy and a central neck dissection after discovery of thyroid nodules by ultrasonography. The intraoperative frozen pathology and postoperative pathology of the 3 cases demonstrated that the lymph nodes contained thyroid follicles without any malignant features, and that the thyroid glands only displayed benign diseases, such as nodular goiter and thyroiditis. The patients remained disease-free for 1 to 6 months without evidence of abnormal cervical lymph nodes at the latest follow-up. The incidence of benign-appearing thyroid follicles in cervical lymph nodes is high.

Benign thyroid inclusions in cervical lymph nodes

JAMA ◽  
1965 ◽  
Vol 194 (1) ◽  
pp. 1-4 ◽  
Author(s):  
A. D. Nicastri
Keyword(s):  
Lymph Nodes ◽  
Cervical Lymph Nodes ◽  
Benign Thyroid
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