Lymphovascular invasion and risk of recurrence in papillary thyroid carcinoma

Wagner, Katy; Abraham, Earl; Tran, Bryan; Roshan, David; Wykes, James; Campbell, Peter; Ebrahimi, Ardalan

doi:10.1111/ans.16202

Cited by 7 publications

(6 citation statements)

References 22 publications

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“…We also found that the size of cancer >3 cm is an independent risk factor for the persistence of the disease, concordant with reports from previous studies (29)(30)(31). A larger tumor size may have an impact on the relative risk of not being cured (29).…”

Section: Discussionsupporting

confidence: 92%

The American Thyroid Association risk stratification and long-term outcomes of differentiated thyroid cancer: a 20-year follow-up of patients in Saudi Arabia

Jammah,

AlSadhan,

Alyusuf

et al. 2023

Front. Endocrinol.

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BackgroundStudies have reported differing factors associated with poor outcomes in patients with differentiated thyroid cancer (DTC). We aimed to describe our 20 years of experience in the management of thyroid cancer (TC) and identify predictors of treatment outcomes.MethodsWe conducted a retrospective review of medical records of patients with TC seen in the Thyroid Center at King Saud University Medical City (KSUMC) in Riyadh, Saudi Arabia, between the years 2000 and 2020. Demographic and clinical data including pathological characteristics were collected. The American Thyroid Association (ATA) risk stratification was determined for all patients at the postoperative period as well as the response to therapy at the final follow-up visit.ResultsA total of 674 patients (mean age: 47.21 years) with TC, 571 (84.7%) of which were women, were included. There were 404 (60.0%) patients with ATA low risk, 127 (18.8%) with intermediate risk, and 143 (21.2%) with high-risk histology. Overall, 461 patients (68.4%) had an excellent response to treatment, 65 (9.6%) had an indeterminate response, 83 (12.3%) had a biochemical incomplete response, and 65 (9.6%) had a structural incomplete response. Patients who had an excellent response were mostly ATA low risk (n = 318 of 431, 68.1%), whereas 40 of 65 patients (61.5%) of those with ATA high-risk histology had a structural incomplete response to treatment. There were significantly more women who had an excellent response compared with men. Obesity, lymphovascular invasion, and size of the tumor were significant predictors of worse outcomes to therapy.ConclusionTumor size, lymphovascular invasion, and obesity are strong predictors of a worse response to therapy among patients with TC. Patients with obesity should be carefully followed up regardless of their risk stratification in light of the recent compelling evidence associating obesity with thyroid cancer and its higher risk of a worse disease outcome. ATA risk stratification is well correlated with patient long-term outcomes.

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Section: Discussionsupporting

confidence: 92%

The American Thyroid Association risk stratification and long-term outcomes of differentiated thyroid cancer: a 20-year follow-up of patients in Saudi Arabia

Jammah,

AlSadhan,

Alyusuf

et al. 2023

Front. Endocrinol.

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“…Additionally, the presence of LI in p-PTMCs was related with the presence of LNM. Although the results of some studies suggest an association between LI of PTMC and PTC and the LNM [24,[34][35][36][37], there is general agreement that only the blood vessel invasion has a prognostic value [38]. Vascular and lymphatic endothelial cells immunohistochemical markers were not used in this study to prevent misinterpretation of LI from its histological mimics [36,39] constituting a limitation.…”

Section: Discussionmentioning

confidence: 98%

Peripheral Versus Intraparenchymal Papillary Thyroid Microcarcinoma: Different Morphologies and PD-L1 Expression

Kovačević

Vučević

Cerović

et al. 2021

Head and Neck Pathol

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Peripheral localisation of papillary thyroid microcarcinoma (PTMC), in comparison with intraparenchymal PTMC (i-PTMC) is related to some clinicopathological features related with biological aggressiveness, including lymph node metastasis (LNM). The expression of PD-L1 in tumour cell has been associated with increased tumour survival, progression, and potentially an aggressive clinical course. This study evaluates the relation between clinicopathological features of PTMC, including tumour localisation, with PD-L1 immunoexpression. The study included 99 patients with the histological diagnosis of PTMC (≥ 5 mm). PD-L1 protein expression was assessed by immunohistochemistry. PTMCs were divided into the four following groups: G1-peripherally localised PTMC (p-PTMC) with PD-L1 expression; G2-p-PTMC without PD-L1 expression; G3-i-PTMC with PD-L1 expression and G4-i-PTMC without PD-L1 expression. G1 was the most frequent (n = 46; 46.5%), followed by G4 (n = 25; 25.3%) and similar distribution of G3 (n = 15; 15.2%) and G2 (n = 13; 13.1%). In comparison with other groups, G1 was significantly associated with classical morphology, invasive growth, lymphatic invasion (LI), vascular invasion (VI), psammoma bodies, intratumoral fibrosis, PD-L1 positive tumour-infiltrating lymphocytes, and multinuclear giant cells (MGCs). G4 more commonly exhibited follicular morphology, expansive/circumscribed growth, and absence of the following: intratumoural fibrosis, LI, VI, psammoma bodies, PD-L1 positive tumour-infiltrating lymphocytes, and MGCs. LNMs were significantly more frequent in G1 in comparison with the other groups (p = 0.000). In conclusion, morphology and tumour microenvironment of p-PTMC with PD-L1 expression is different from i-PTMC without PD-L1 expression. The differences between these two groups of PTMC include clinicopathological features related with biological aggressiveness such as the occurrence of LNM.

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“…Lymphovascular invasion in thyroid cancer is defined as the movement of cancer cells into the blood vessels and/or lymphatic vessels, as observed in histopathology. 13 In a previous study, Kim and co‐workers confirmed the existence of a significant correlation between lymphatic vessel invasion and lateral neck lymph node metastasis, as revealed by an analysis of 662 patients with papillary thyroid cancer. 14 Meta‐analysis performed by Yoon and co‐workers also showed that lymphovascular invasion was significantly related to metastasis of contralateral cervical lymph nodes, especially in the case of level-III and -IV lymph node.…”

Section: Discussionmentioning

confidence: 83%

Risk Factors for Level-VII Lymph Node Metastases of Thyroid Neoplasms: A Meta-Analysis

Ruo

Xiao²,

Ming

et al. 2022

The American Surgeon™

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Objective The present study conducted a meta-analysis to forecast the risk factors associated with level-VII lymph node metastases in case of thyroid neoplasms, intending to assist in determining the requirement for level-VII lymph node lymphadenectomy during the surgery. Methods Electronic databases, PubMed, Embase, the Cochrane Library, CNKI, Wanfang Data, VIP, and CBM electronic databases were searched for studies focused on level-VII lymph node metastases in thyroid neoplasms, published up to April 2021. Stata 13.1 software was used for analyses. Results The literature search identified a total of 997 studies. Among these, 8 studies, involving 1813 patients, were included in the present case. All these studies were case-control studies. Results for meta‐analysis showed that male (OR = 1.340, 95% CI: 1.018-1.764, P = .037), age < 45 years (OR = 4.178, 95% CI: 1.601–10.908, P = .003), tumor size ≥ 2.0 cm (OR = 1.960, 95% CI: 1.079-3.562, P = .027), extrathyroidal extension (OR = 2.037, 95% CI: 1.578-2.630, P < .001), distant metastasis (OR = 2.775, 95% CI: 2.005-3.840, P < .001), central lymph node metastasis (OR = 3.500, 95% CI: 1.127-10.874, P = .03), contralateral cervicolateral metastasis (OR = 2.119, 95% CI: 1.514-2.965, P < .001), and bilateral nodal metastasis (OR = 4.651, 95% CI: 2.697-8.020, P < .001) acted as risk factors for level-VII lymph node metastases. In addition to this, sensitivity analyses and bias test showed that the results of meta‐analysis were reliable and stable and involved no publication bias. Conclusion In the present study, male gender, age < 45 years, tumor size ≥ 2.0 cm, extrathyroidal extension, distant metastasis, central lymph node metastasis, contralateral cervicolateral metastasis, and bilateral nodal metastasis were identified as risk factors for level-VII lymph node metastases in case of thyroid neoplasms.

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Lymphovascular invasion and risk of recurrence in papillary thyroid carcinoma

Cited by 7 publications

References 22 publications

The American Thyroid Association risk stratification and long-term outcomes of differentiated thyroid cancer: a 20-year follow-up of patients in Saudi Arabia

The American Thyroid Association risk stratification and long-term outcomes of differentiated thyroid cancer: a 20-year follow-up of patients in Saudi Arabia

Peripheral Versus Intraparenchymal Papillary Thyroid Microcarcinoma: Different Morphologies and PD-L1 Expression

Risk Factors for Level-VII Lymph Node Metastases of Thyroid Neoplasms: A Meta-Analysis

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