Male Gender Is Associated with Lymph Node Metastasis but Not with Recurrence in Papillary Thyroid Carcinoma

Abstract

Background. The incidence of papillary thyroid carcinoma (PTC) is higher in females than in males, but it remains unclear whether gender is associated with the aggressiveness of this disease. We aimed to clarify the influence of gender on the risk of developing lymph node metastasis (LNM) and on the prognosis of PTC patients. Study Design. Retrospective cohort study. Setting. Academic tertiary care center. Methods. Clinical data of PTC patients who were admitted to the Department of Endocrine and Breast Surgery, the First Affiliated Hospital of Chongqing Medical University, between January 2013 and December 2018 were retrospectively reviewed. The differences in clinical features and outcomes between female and male patients were compared. Univariate and multivariate logistic regression analyses were conducted to assess the impact of gender on LNM. Kaplan–Meier curves were used to estimate recurrence-free survival (RFS). Results. A total of consecutive 2536 patients were enrolled in this study. Males accounted for 25.2% (639 cases) of all patients. Central lymph node metastasis (CLNM) and lateral lymph node metastasis (LLNM) rates were 52.5% (1346/2536) and 22.0% (558/2536), respectively. Male presented with higher LNM rates than female patients (65.7% vs. 51.2%; P < 0.001 ). Male gender was independently associated with LNM (OR = 1.93, 95% CI: 1.59–2.35; P < 0.001 ). After full adjustment, male gender still remained significantly associated with CLNM in all subgroups; however, subgroup analyses indicated no significant relationship between gender and LLNM. In addition, after a median follow-up period of 30 months, no significant difference was found in RFS between female and male patients ( P = 0.15 ). Conclusions. This observational cohort study revealed that male gender was significantly associated with CLNM; whereas, LLNM was not different between female and male PTC patients in southwestern China. Moreover, currently, there is insufficient evidence to justify that male gender is an independent prognostic factor for recurrence.

Prediction of cervical lymph node metastasis in solitary papillary thyroid carcinoma based on ultrasound radiomics analysis

“…This is consistent with a recent study that also showed a negative correlation between age and CLNM, despite different age group cutoffs (15). Our study also revealed a higher CLNM detection rate in males, which is consist with the observations of Zhu et al (16). The negative correlation in females may be related to hormonal and reproductive factors (17).…”

“…Our study also revealed a higher CLNM detection rate in males, which is consist with the observations of Zhu et al. ( 16 ). The negative correlation in females may be related to hormonal and reproductive factors ( 17 ).…”

Analysis of risk factors for lateral lymph node metastasis in T1 stage papillary thyroid carcinoma: a retrospective cohort study

“…Aligning with Mao et al ’s meta-analysis ( 14 ), our study reaffirms male sex as a risk factor for LLNM in T1 stage PTC patients, highlighting a higher propensity for LLNM in men. This gender-based disparity in LLNM incidence aligns with several studies ( 15 , 33 ), although it remains a subject of debate in other research ( 34 , 35 ). Notably, the adverse prognosis associated with PTC tends to be more pronounced in men, despite its higher prevalence in women ( 36 ).…”

Lymph Node Ratio Predicts Recurrence in Patients with Papillary Thyroid Carcinoma with Low Lymph Node Yield

“…Thus, a great deal of research has been conducted to investigate the various risk factors associated with LN metastasis in PTC. Several risk factors significantly associated with LN metastasis in patients with PTC were identified in previous studies, including male gender, younger age, larger tumor size, multifocality, ETE, and lymphovascular invasion [14][15][16][17][18]. The identification of these risk factors facilitates the development of effective screening, diagnosis, and treatment strategies for patients with PTC at risk of LN metastasis.…”