Clinical and ultrasonic risk factors for high‐volume central lymph node metastasis in cN0 papillary thyroid microcarcinoma: A retrospective study and meta‐analysis

Wang, Zhiyuan; Gui, Zhiqiang; Wang, Zhihong; Huang, Jiapeng; He, Liang; Dong, Wenwu; Zhang, Dalin; Zhang, Ting; Shao, Liang; Shi, Jinyuan; Wu, Pu; Ji, Xiaoyu; Zhang, Hao; Sun, Wei

doi:10.1111/cen.14834

Cited by 11 publications

(14 citation statements)

References 74 publications

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“…Hence future studies could research the difference between contralateral and ipsilateral CLNM with BRAF mutation. CLNM is usually present in 17%–64% of patients with PTMC, and even in cN0 PTMC, up to 34.8% to 60.9% of patients develop CLNM 38 . Our analysis showed that cN0 PTMC with BRAF mutation were more likely to have CLNM (OR = 1.70, 95% CI: 1.40–2.07).…”

Section: Discussionmentioning

confidence: 56%

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Gene mutations as predictors of central lymph mode metastasis in cN0 PTC: A meta‐analysis

Ji,

Shi

2023

Clinical Genetics

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Gene mutations could predict the tumor progression and prognosis, which are us to predict CLNM in patients with cN0 PTC, however, these results are not consistent. This meta‐analysis tried to identify gene mutations which could predict CLNM in patients with cN0 PTC. A systematic search was performed for identifying relevant literature published prior to July 2023 in three search engines: PubMed, EMBASE and Web of Science. Studies that investigated the gene mutations for CLNM in patients with cN0 PTC were included in our meta‐analysis. Sixteen studies, including 6095 cN0 PTC with BRAF mutations were include in our meta‐analysis. The prevalence of CLNM in cN0 PTC ranged from 13.7% to 50.6%. The pooled analysis demonstrated that BRAFV600E mutation is significantly associated with CLNM (OR = 2.01, 95% CI: 1.55–2.60, p < 0.001) in PTC and PTMC (OR = 1.70, 95% CI: 0.51–1.81, p < 0.001). Whereas, cN0 PTC with TERT (OR = 1.94, 95% CI: 0.51–7.36, p = 0.33) and KRAS (OR = 0.57, 95% CI: 0.51–1.81, p = 0.34) mutations might not contribute to predict CLNM. Our analysis identified that BRAF mutation was a predictive factor for cN0 PTC, as well as for cN0 PTMC, which could be useful for clinician to accurately choose prophylactic CLND and better manage cN0 PTC.

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Section: Discussionmentioning

confidence: 56%

“…CLNM is usually present in 17%-64% of patients with PTMC, and even in cN0 PTMC, up to 34.8% to 60.9% of patients develop CLNM. 38 Our analysis showed that cN0 PTMC with BRAF mutation were more likely to have CLNM (OR = 1.70, 95% CI:…”

Section: Resultsmentioning

confidence: 68%

Gene mutations as predictors of central lymph mode metastasis in cN0 PTC: A meta‐analysis

Ji,

Shi

2023

Clinical Genetics

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“…In addition to the Rad score, age and capsule invasion were independent risk factors for CLNM. In most previous studies, younger age was closely correlated with a high incidence of CLNM irrespective of the threshold [ 12 , 21 – 22 ]. This may be explained by the negative association between age and PTMC promotion rate [ 23 ].…”

Section: Discussionmentioning

confidence: 85%

“…Screening patients at high preoperative risk of CLNM is crucial to determining the indications for PCLND [ 12 ]. Numerous studies have analyzed the risk factors for CLNM in patients with cN0 PTMC.…”

Section: Introductionmentioning

confidence: 99%

Ultrasound radiomics signature for predicting central lymph node metastasis in clinically node-negative papillary thyroid microcarcinoma

Liu,

Yu,

Wei

et al. 2024

Thyroid Res

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Background Whether prophylactic central lymph node dissection is necessary for patients with clinically node-negative (cN0) papillary thyroid microcarcinoma (PTMC) remains controversial. Herein, we aimed to establish an ultrasound (US) radiomics (Rad) score for assessing the probability of central lymph node metastasis (CLNM) in such patients. Methods 480 patients (327 in the training cohort, 153 in the validation cohort) who underwent thyroid surgery for cN0 PTMC at two institutions between January 2018 and December 2020 were included. Radiomics features were extracted from the US images. Least absolute shrinkage and selection operator logistic regression were utilized to generate a Rad score. A nomogram consisting of the Rad score and clinical factors was then constructed for the training cohort. Both cohorts assessed model performance using discrimination, calibration, and clinical usefulness. Results Based on the six most valuable radiomics features, the Rad score was calculated for each patient. A multivariate analysis revealed that a higher Rad score (P < 0.001), younger age (P = 0.006), and presence of capsule invasion (P = 0.030) were independently associated with CLNM. A nomogram integrating these three factors demonstrated good calibration and promising clinical utility in the training and validation cohorts. The nomogram yielded areas under the curve of 0.795 (95% confidence interval [CI], 0.745–0.846) and 0.774 (95% CI, 0.696–0.852) in the training and validation cohorts, respectively. Conclusions The radiomics nomogram may be a clinically useful tool for the individual prediction of CLNM in patients with cN0 PTMC.

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“…For example, the meta-analysis of Wang et al. ( 26 ) defined high-volume lymph node metastasis in PTC as involving >5 lymph nodes. At the same time, Huang et al.…”

Section: Discussionmentioning

confidence: 99%

Nomogram model based on preoperative clinical characteristics of unilateral papillary thyroid carcinoma to predict contralateral medium-volume central lymph node metastasis

Wu,

Huang,

Huang

et al. 2024

Front. Endocrinol.

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ObjectivesTo explore the preoperative high-risk clinical factors for contralateral medium-volume central lymph node metastasis (conMVCLNM) in unilateral papillary thyroid carcinoma (uPTC) and the indications for dissection of contralateral central lymph nodes (conCLN).MethodsClinical and pathological data of 204 uPTC patients who underwent thyroid surgery at the Hangzhou First People’s Hospital from September 2010 to October 2022 were collected. Univariate and multivariate logistic regression analyses were conducted to determine the independent risk factors for contralateral central lymph node metastasis (conCLNM) and conMVCLNM in uPTC patients based on the preoperative clinical data. Predictive models for conCLNM and conMVCLNM were constructed using logistic regression analyses and validated using receiver operating characteristic (ROC) curves, concordance index (C-index), calibration curves, and decision curve analysis (DCA).ResultsUnivariate and multivariate logistic regression analyses showed that gender (P < 0.001), age (P < 0.001), tumor diameter (P < 0.001), and multifocality (P = 0.008) were independent risk factors for conCLNM in uPTC patients. Gender(P= 0.026), age (P = 0.010), platelet-to-lymphocyte ratio (PLR) (P =0.003), and tumor diameter (P = 0.036) were independent risk factors for conMVCLNM in uPTC patients. A predictive model was established to assess the risk of conCLNM and conMVCLNM, with ROC curve areas of 0.836 and 0.845, respectively. The C-index, the calibration curve, and DCA demonstrated that the model had good diagnostic value.ConclusionGender, age, tumor diameter, and multifocality are high-risk factors for conCLNM in uPTC patients. Gender, age, tumor diameter, and PLR are high-risk factors for conMVCLNM in uPTC patients, and preventive conCLN dissection should be performed.

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Clinical and ultrasonic risk factors for high‐volume central lymph node metastasis in cN0 papillary thyroid microcarcinoma: A retrospective study and meta‐analysis

Cited by 11 publications

References 74 publications

Gene mutations as predictors of central lymph mode metastasis in cN0 PTC: A meta‐analysis

Gene mutations as predictors of central lymph mode metastasis in cN0 PTC: A meta‐analysis

Ultrasound radiomics signature for predicting central lymph node metastasis in clinically node-negative papillary thyroid microcarcinoma

Nomogram model based on preoperative clinical characteristics of unilateral papillary thyroid carcinoma to predict contralateral medium-volume central lymph node metastasis

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