Lymph node metastasis of papillary thyroid carcinoma in the context of Hashimoto’s thyroiditis

Wang, Lirong; Chen, Jiawen; Yuan, Xin; Wang, Juan; Sun, Lei; Jiang, Jue; Zhang, Lin; Liu, Min; Zhou, Qi

doi:10.1186/s12902-021-00923-2

Cited by 11 publications

(7 citation statements)

References 37 publications

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“…The present study discovered that ETE is a risk factor for CLNM and LLNM in MPTC. However, Hashimoto’s thyroiditis was not classified as a risk factor for CLNM and LLNM, which was inconsistent with published results ( 37 , 38 ). This discrepancy might be caused by differences in the selection criteria and study designs.…”

Section: Discussioncontrasting

confidence: 86%

Risk factors of cervical lymph node metastasis in multifocal papillary thyroid cancer

Zhang

Wang

et al. 2022

Front. Oncol.

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IntroductionIdentifying risk variables for cervical lymph node metastases in multifocality papillary thyroid cancer (MPTC) could assist surgeons in determining whether cervical lymph node dissection would be an appropriate surgical option.MethodsA retrospective cohort of 2006 patients with papillary thyroid cancer were selected. MPTC (N = 460) was defined as the presence of two or more foci of PTC. The risk factors for central lymph node metastasis (CLNM) and lateral lymph node metastasis (LLNM) in MPTC were investigated by univariate and multivariate analyses, including the following items: age at diagnosis, gender, Hashimoto’s thyroiditis, extrathyroidal extension (ETE), maximal axial diameter (MAD) and the sum of axial diameters (SAD) of tumor. In addition, CLNM was used to evaluate LLNM.ResultsThe incidence of CLNM and LLNM was 44.57% and 17.17%, respectively. The multivariate analysis demonstrated that gender, extrathyroidal extension (ETE), age, maximal axial diameter (MAD), and the sum of axial diameters (SAD) were related to increased risk for CLNM in MPTC (p < 0.05). The area under the receiver operating characteristic (ROC) curve (AUC) for age at diagnosis of CLNM was 0.647, the cut-off value was 50 years old. Additionally, by multivariate analysis, CLNM, ETE, MAD, and SAD were independent risk factors for LLNM in MPTC (p < 0.05). ROC curve analysis demonstrates that AUC for MAD and SAD diagnosis of LLNM were 0.639 and 0.757, and the cut-off values were 16 and 26 mm, respectively.ConclusionsMPTC patients who have risk factors for CLNM were advised to perform prophylactic central lymph node dissection (CLND). Additionally, the presence of risk factors for LLNM should be individually evaluated and analyzed for the necessity of lateral lymph node dissection.

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Section: Discussioncontrasting

confidence: 86%

Risk factors of cervical lymph node metastasis in multifocal papillary thyroid cancer

Zhang

Wang

et al. 2022

Front. Oncol.

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“…Many authors have reported a considerably better prognosis of DTC when HT is also present; however, these data are not uniform in the various studies, as some report a greater presence of multifocal carcinomas and a similar recurrence rate to non-HT tumors (20, 21), while others show a greater presence of microcarcinomas, with a smaller average tumor size and a lower incidence of lymph node metastases and extrathyroidal extension, leading to significantly better disease-free survival for DTCs with concomitant HT than for those without HT (16,22,23,38).…”

Section: Discussionmentioning

confidence: 99%

Association between hashimoto thyroiditis and differentiated thyroid cancer: A single-center experience

et al. 2022

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Hashimoto’s thyroiditis is the most common cause of hypothyroidism in the iodine-sufficient areas of the world. Differentiated thyroid cancer is the most common thyroid cancer subtype, accounting for more than 95% of cases, and it is considered a tumor with a good prognosis, although a certain number of patients experience a poor clinical outcome. Hashimoto’s thyroiditis has been found to coexist with differentiated thyroid cancer in surgical specimens, but the relationship between these two entities has not yet been clarified. Our study aims to analyze the relationship between these two diseases, highlighting the incidence of histological diagnosis of Hashimoto thyroiditis in differentiated thyroid cancer patients, and assess how this autoimmune disorder influences the risk of structural disease recurrence and recurrence rate.

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“…Some studies identified HT as an independent risk factor for thyroid cancer. The proportion of multifocality in PTC patients with HT is higher than in those without, while the incidence of lymph node metastasis is comparable ( 30 , 31 ). Salvatore Ulisse et al.…”

Section: Discussionmentioning

confidence: 96%

Risk prediction for central lymph node metastasis in isolated isthmic papillary thyroid carcinoma by nomogram: A retrospective study from 2010 to 2021

Zhao

Shi²,

Fang³

et al. 2023

Front. Endocrinol.

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BackgroundIsthmic papillary thyroid carcinoma (IPTC) is an aggressive thyroid cancer associated with a poor prognosis. Guidelines elaborating on the extent of surgery for IPTC are yet to be developed. This study aims to construct and validate a model to predict central lymph node metastasis (CLNM) in patients with IPTC, which could be used as a risk stratification tool to determine the best surgical approach for patients.MethodsElectronic medical records for patients diagnosed with isolated papillary thyroid carcinoma who underwent surgery at Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, from January 2010 to December 2021 were reviewed. All patients who underwent thyroidectomy with central neck dissection (CND) for isolated IPTC were included. We conducted univariate and multivariate logistic regression analyses to assess risk factors for ipsilateral and contralateral CLNM and the number of CLNM in IPTC patients. Based on the analysis, the nomogram construction and internal validations were performed.ResultsA total of 147 patients with isolated IPTC were included. The occurrence of CLNM was 53.7% in the patients. We identified three predictors of ipsilateral CLNM, including age, gender, and size. For contralateral CLNM, three identified predictors were age, gender, and capsular invasion. Predictors for the number of CLNM included age, gender, capsular invasion, tumor size, and chronic lymphocytic thyroiditis (CLT). The concordance index(C-index) of the models predicting ipsilateral CLNM, contralateral CLNM, 1-4 CLNM, and ≥5 CLNM was 0.779 (95%CI, 0.704, to 0.854), 0.779 (95%CI, 0.703 to 0.855), 0.724 (95%CI, 0.629 to 0.818), and 0.932 (95%CI, 0.884 to 0.980), respectively. The corresponding indices for the internal validation were 0.756 (95%CI, 0.753 to 0.758), 0.753 (95%CI, 0.750 to 0.756), 0.706 (95%CI, 0.702 to 0.708), and 0.920 (95%CI, 0.918 to 0.922). Receiver operating characteristic (ROC) curves, calibration, and decision curve analysis (DCA) results confirmed that the three nomograms could precisely predict CLNM in patients with isolated IPTC.ConclusionWe constructed predictive nomograms for CLNM in IPTC patients. A risk stratification scheme and corresponding surgical treatment recommendations were provided accordingly. Our predictive models can be used as a risk stratification tool to help clinicians make individualized surgical plans for their patients.

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Lymph node metastasis of papillary thyroid carcinoma in the context of Hashimoto’s thyroiditis

Cited by 11 publications

References 37 publications

Risk factors of cervical lymph node metastasis in multifocal papillary thyroid cancer

Risk factors of cervical lymph node metastasis in multifocal papillary thyroid cancer

Association between hashimoto thyroiditis and differentiated thyroid cancer: A single-center experience

Risk prediction for central lymph node metastasis in isolated isthmic papillary thyroid carcinoma by nomogram: A retrospective study from 2010 to 2021

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