COMPLICATION OF TOTAL THYROIDECTOMY PLUS LYMPH NODE GROUP VI DISSECTION IN PAPILLARY THYROID CARCINOMA PATIENTS

2016 ◽  
pp. 124-129
Author(s):  
Tran Thuc Huan Nguyen ◽  
Phuong Phung ◽  
Dinh Tung Nguyen ◽  
Viet Dung Nguyen ◽  
Thanh Huy Le
Keyword(s):  
Lymph Node ◽  
Papillary Thyroid Carcinoma ◽  
Thyroid Carcinoma ◽  
Lymph Nodes ◽  
Total Thyroidectomy ◽  
Recurrence Rate ◽  
Papillary Thyroid ◽  
Group Vi ◽  
Neck Lymph Node ◽  
Node Group

Background: Although lymph-node metastases are common in papillary thyroid cancer, there is considerable debate concerning the use of routine prophylactic lymph-node group VI dissection for all patients undergoing total thyroidectomy. This study was identification the complications and the rate of recurrence of total thyroidectomy plus lymph node group VI dissection in papillary thyroid carcinoma patients. Materials and methods: A prospective study was conducted on 60 patients with papillary thyroid carcinoma. They underwent total thyroidectomy with or without lymph node group VI dissection. Evaluation of postoperative complications and early recurrence rate /distant metastasis after 2 years. Results: The incident of transient hypoparathyroidism in the grouptotal thyroidectomy with or without lymph node group VI dissection respectively 13.3% and 6.7%. Neck lymph node dissection group VI helps detect 40.9% of cases of metastatic lymph nodes clinically undetectable. Neck lymph node recurrence rate in patients with lymph node group VI dissection is lower than group without dissection (3.3% versus 23.3%). Conclusions: Lymph nodes group VIdissection in preventive treatment of papillary thyroid carcinoma should be done. Key words: PTC, lymph-node group VI dissection

scholarly journals Predictors of thyroglobulin in the lymph nodes recurrence of papillary thyroid carcinoma undergoing total thyroidectomy

BMC Surgery ◽  
2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Zhichao Xing ◽  
Yuxuan Qiu ◽  
Zhe Li ◽  
Lingyun Zhang ◽  
Yuan Fei ◽  
...  
Keyword(s):  
Papillary Thyroid Carcinoma ◽  
Thyroid Carcinoma ◽  
Lymph Nodes ◽  
Total Thyroidectomy ◽  
Radioactive Iodine ◽  
Independent Predictor ◽  
Central Neck Dissection ◽  
American Thyroid Association ◽  
Papillary Thyroid ◽  
Serum Thyroglobulin

Abstract Background To investigate the association between postoperative lymph nodes (LNs) recurrence and distinct serum thyroglobulin (Tg) levels in patients with papillary thyroid carcinoma (PTC). Methods This study included PTC patients who underwent total thyroidectomy (TT) with at least central neck dissection and then re-operated due to recurrence of LNs between January 2013 and June 2018. These patients were grouped by negative or positive serum Tg levels according to the American Thyroid Association guidelines. Results Of the 60 included patients, 49 underwent radioactive iodine (RAI) treatment. Maximum unstimulated Tg (uTg) ≥ 0.2 ng/mL were associated with larger diameter of recurrent LNs (P = 0.027), and higher rate of metastatic LNs (P < 0.001). Serum-stimulated Tg (off-Tg) ≥ 1 ng/mL (P = 0.047) and unstimulated Tg (on-Tg) ≥ 0.2 ng/Ml (P = 0.013) were associated with larger diameter of recurrent LNs. Number of metastatic LNs ≥ 8 was an independent predictor for postoperative maximum uTg ≥ 0.2 ng/mL (OR = 8.767; 95% CI = 1.392–55.216; P = 0.021). Ratio of metastatic LNs ≥ 25% was an independent predictor for off-Tg ≥ 1 ng/mL (OR = 20.997; 95% CI = 1.649–267.384; P = 0.019). Conclusion Postoperative Tg-positive status was associated with larger size of recurrent LNs. Number of metastatic LNs ≥ 8 and ratio of metastatic LNs ≥ 25% were independent predicators for uTg-positive and off-Tg-positive status, respectively.

Simultaneous Metastatic Papillary Thyroid Carcinoma and Carcinoid of the Small Intestine in the Cervical Lymph Node Group

Thyroid ◽  
2010 ◽  
Vol 20 (9) ◽  
pp. 1025-1028
Author(s):  
Konstantinos D. Markou ◽  
John K. Goudakos ◽  
Stefanos Triaridis ◽  
Despoina Televantou ◽  
Prodromos Hytiroglou ◽  
...  
Keyword(s):  
Small Intestine ◽  
Lymph Node ◽  
Papillary Thyroid Carcinoma ◽  
Thyroid Carcinoma ◽  
Cervical Lymph Node ◽  
Papillary Thyroid ◽  
Node Group

scholarly journals Incidental Diffuse Sclerosing Variant Papillary Thyroid Cancer in Grave’s Disease

2021 ◽  
Vol 5 (Supplement_1) ◽  
pp. A891-A892
Author(s):  
Nicolle Canales ◽  
Yadiel Rivera Nieves ◽  
Nydia Ivette Burgos Ortega ◽  
Janet Marie Colon Castellano ◽  
Nicole Hernández Cordero ◽  
...  
Keyword(s):  
Thyroid Cancer ◽  
Lymph Node ◽  
Papillary Thyroid Carcinoma ◽  
Thyroid Carcinoma ◽  
Total Thyroidectomy ◽  
Papillary Thyroid Cancer ◽  
Outpatient Basis ◽  
Thyroid Function Tests ◽  
Papillary Thyroid ◽  
Diffuse Sclerosing Variant

Abstract The diffuse sclerosing variant papillary thyroid carcinoma (DSPTC) is an uncommon form of this neoplasm. Some studies describe its high propensity for tumor invasion, metastasis, and mortality compared with classic papillary thyroid carcinoma. Histologic features of DSPTC may resemble diffuse inflammation as seen with Grave’s or Hashimoto’s thyroiditis, which makes initial diagnosis challenging. A 27-year-old female with Noonan’s Syndrome was evaluated on an outpatient basis after developing atrial fibrillation de novo. Thyroid function tests were consistent with hyperthyroidism with TSH: &lt;0.005 (n: 0.300-3.000 uIU/mL), FT4: 3.59 (0.71-1.85 ng/mL) and FT3: 16.77 (n: 2.0-7.0 pmol/L). Diffuse goiter was noted on physical exam, but no ophthalmopathy or dermopathy was present. TRAB and TSI were elevated at 38.4 (n: &lt;16%) and 423% (n: &lt;140%) respectively. A twenty-four-hour radioiodine uptake was 48% (n:10-35%) and described as essentially homogenous with two foci of decreased radiotracer concentration suggestive of cold nodules. Thyroid ultrasound showed diffuse nodularity bilaterally with associated clusters of calcifications and no discrete nodules. No abnormal appearing lymph nodes were identified. Fine-needle aspiration of both nodular areas was positive for DSPTC. Total thyroidectomy with central neck dissection was performed. Gross and microscopic post-surgical pathology confirmed the presence of diffuse sclerosing papillary thyroid cancer, along with local metastasis to one central lymph node. Patient was scheduled for radioactive iodine therapy. Diffuse sclerosing variant is considered an aggressive histotype of papillary thyroid cancer. Ultrasound features include diffuse scattered microcalcifications with or without discrete nodules that may be confused with chronic inflammatory changes. Despite the limited number of cases, DSPTC is recognized to have specific characteristics, a high female to male ratio, and a young patient age. DSPTC has a high potential for aggressive biologic behavior if not treated promptly at the time of diagnosis. When suspected, total thyroidectomy with lymph node excision followed by radioiodine therapy has been proposed as the correct management to decrease the risk of persistent or recurrent disease.

scholarly journals Incidence and Clinical Significance of Delphian Lymph Node Metastasis in Unilateral Papillary Thyroid Carcinoma

2020 ◽  
Author(s):  
Wei Liu ◽  
Zhenglin Wang ◽  
Cong Wang ◽  
Zhilong Ai
Keyword(s):  
Lymph Node ◽  
Papillary Thyroid Carcinoma ◽  
Thyroid Carcinoma ◽  
Lymph Nodes ◽  
Clinical Significance ◽  
Tumor Size ◽  
Frozen Section ◽  
Extrathyroidal Extension ◽  
Capsular Invasion ◽  
Papillary Thyroid

Abstract Background: Some studies have reported that Delphian lymph node (DLN) metastasis is associated with a poor prognosis of papillary thyroid carcinoma (PTC), but the number of the available studies is limited and the results are inconsistent. The aim of this investigation was to study the incidence and clinical significance of DLN metastasis in patients with unilateral PTC.Methods: This was a cross-sectional study from January 2016 to December 2019. The data were obtained from the department of general surgery in Shanghai Zhongshan Hospital affiliated to Fudan University. This study included 522 patients with unilateral PTC and had DLN harvested. The associations between DLN metastasis and the clinical characteristics of the patients, i.e. age, sex, tumor size, multifocality, capsular invasion, extrathyroidal extension, central lymph nodes (CLN) metastasis (excluding DLN), and lateral lymph nodes (LLN) metastasis was analyzed.Results: Among all the 522 patients, 133 (25.5%) patients had metastasized DLN lymph nodes. DLN metastasis was significantly associated with age (p = 0.047), male (p < 0.001), larger tumor size (p < 0.001), capsular invasion (p < 0.001), extrathyroidal extension (p = 0.004), tumor location in upper third (p = 0.003), other CLN metastasis (p < 0.001), number of positive CLN (excluding DLN) (p < 0.001), LLN metastasis (p = 0.036), number of positive LLN (p = 0.004) and number of DLN removed (p = 0.043). No association was found between DLN metastasis and multifocality, number of CLN removed and number of LLN removed.Conclusions: DLN metastasis is associated with some adverse prognostic markers of PTC. If the DLN is positive on intraoperative frozen section, careful dissection of CLN and careful evaluation of LLN are essential, and intensive follow-up should be warranted.

scholarly journals The Clinical and Prognosis Value of the Number of Metastatic Lymph Nodes in Papillary Thyroid Carcinoma Patients

2020 ◽  
Author(s):  
Ling Zhan ◽  
Hong-fang Feng ◽  
Xi-zi Yu ◽  
Ling-rui Li ◽  
Jun-long Song ◽  
...  
Keyword(s):  
Lymph Node ◽  
Papillary Thyroid Carcinoma ◽  
Thyroid Carcinoma ◽  
Lymph Nodes ◽  
Tumor Size ◽  
Tumor Diameter ◽  
Papillary Thyroid ◽  
Metastatic Lymph Nodes ◽  
Metastatic Lymph ◽  
High Prevalence

Abstract Objective: It has been reported that papillary thyroid carcinoma (PTC) patients with lymph node metastasis (LNM) are more associated with adverse outcomes. This study aimed to assess the correlation between the lymph node (LN) status and clinical prognosis in PTC patients. Methods: We retrospectively reviewed the medical records of PTC patients who underwent initial thyroid cancer surgery in Renmin Hospital of Wuhan University between 2017 and 2019. 1021 PTC patients with total checked number of lymph nodes ≥5 were involved in this study. The clinicopathological characteristics of patients were compared according to the LN status and the number of metastatic lymph nodes (NMLNs). Results: The LNM and NMLNs>5 were seen in 694 (68.0%) and 222 (21.7%) cases, respectively. Young patients, patients with larger tumor diameter, bilaterality, multifocality and gross extrathyroidal extension (ETE) were more inclined to LNM and NMLNs >5 (P<0.001). The patients with LNM (pN1) were mainly among males and were exhibited multifocality and advanced tumor stage (P<0.001), while pN1 patients with NMLNs >5 were negatively associated with advanced tumour stage (P<0.05). Recurrence-free survival among pN1 patients was significantly different between 2 groups (NMLNs ≤5: 0/472, 100.0%; NMLNs >5: 5/222, 97.7%; P=0.002). In multivariate logistic regression analysis, the male (OR=2.580, P<0.001), 10-mm tumor size (OR=1.770, P<0.001), tumor gross ETE (OR=2.004, P<0.001) were independent predictors for the high prevalence of LNM. Similarly, 10-mm tumor size (OR=1.399, P<0.05), bilaterality (OR=2.350, P<0.001) and tumor gross ETE (OR=2.660, P<0.05) were also independent predictors for the high prevalence of NMLNs >5; 10-year age was an independent predictor for the low prevalence of the LNM (OR=0.658, P<0.001) and NMLNs >5 (OR=0.678, P<0.001). Conclusions: The status of the cervical LNs and the NMLNs should be correctly evaluated to guide reasonable treatment and careful follow-up.

scholarly journals Predictors of Thyroglobulin in the Lymph Nodes Recurrence of Papillary Thyroid Carcinoma Undergoing Total Thyroidectomy

2020 ◽  
Author(s):  
Zhichao Xing ◽  
Yuxuan Qiu ◽  
Zhe Li ◽  
Lingyun Zhang ◽  
Yuan Fei ◽  
...  
Keyword(s):  
Papillary Thyroid Carcinoma ◽  
Thyroid Carcinoma ◽  
Lymph Nodes ◽  
Total Thyroidectomy ◽  
Radioactive Iodine ◽  
Independent Predictor ◽  
Structural Features ◽  
Papillary Thyroid ◽  
Serum Thyroglobulin ◽  
Positive Ratio

Abstract Purpose To investigate serum thyroglobulin (Tg) levels in papillary thyroid carcinoma (PTC) patients with lymph nodes (LNs) recurrence, thereby evaluating possible risk factors and structural features of LNs recurrence. Methods All the patients with primary PTC who underwent total thyroidectomy (TT) with central or lateral neck dissection and then re-operated due to LNs recurrence between January 2013 and June 2018 were included. Patients were subdivided groups by different Tg levels. Results This study included 60 patients with LNs recurrence. Of all, 49 patients underwent radioactive iodine (RAI) treatment. Maximum unstimulated Tg (uTg) ≥ 0.2 ng/mL were associated with larger diameter of recurrent LNs (P = 0.027), higher possibility of diameters of recurrent LNs ≥ 25 mm (P = 0.023) and higher ratio of metastatic LNs (P < 0.001). Pre-RAI ablation serum-stimulated Tg (off-Tg) ≥ 1 ng/mL and unstimulated Tg detected at 1 week after RAI ablation (on-Tg) ≥ 0.2 ng/mL were associated with larger diameter of recurrent LNs and higher possibility of diameters of recurrent LNs ≥ 25 mm. Number of metastatic LNs ≥ 8 was an independent predictor for maximum uTg ≥ 0.2 ng/mL (OR = 8.767; 95% CI = 1.392–55.216; P = 0.021). Ratio of metastatic LNs ≥ 25% was an independent predictor for off-Tg ≥ 1 ng/mL (OR = 20.997; 95% CI = 1.649-267.384; P = 0.019). Conclusion Tg-positive was associated with larger size of recurrent LNs. Number of metastatic LNs ≥ 8 could independently predict maximum uTg-positive. Ratio of metastatic LNs ≥ 25% was an independent predicator for off-Tg-positive.

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