Metastases to the regional lymph nodes, lymph node recurrence, and distant metastases in nonadvanced papillary thyroid carcinoma

Abstract

To investigate the biological characteristics of papillary thyroid carcinoma from the perspectives of lymph node metastasis, lymph node recurrence, and distant metastasis, 746 patients with nonadvanced papillary thyroid carcinoma were retrospectively studied. There were 76 men and 670 women with a mean age of 42.7 years. The rate of lymph node metastasis was significantly higher in young patients (aged less than 30 years). Lymph node recurrence was observed in 80 patients and distant metastasis in 13, being seen with significant frequency in the young and elderly (aged over 50 years) patients and in the men. The frequency of distant metastasis was significantly greater in the elderly patients and in those with lymph node recurrence. These findings indicate that the role of regional lymph nodes and the clinical meaning of lymph node recurrence differ between young and elderly patients.

Prognosis and growth activity depend on patient age in clinical and subclinical papillary thyroid carcinoma [Review]

“…Other research groups have investigated the relationship between lymph node metastasis and patient age. Sugino et al evaluated the cases of 746 patients with "nonadvanced PTC" and reported that lymph node metastasis was more frequently observed in patients < 30 yrs [23]. Ahuja et al showed that lymph node metastases were more frequently positive in patients ≤ 40 yrs [24].…”

“…Sugino et al showed that the rate of lymph node metastasis was high in patients < 30 yrs, and distant recurrence was frequently observed in patients > 50 yrs [23]. Table 4 provides the lymph node and distant recurrence rates of 5,784 patients according to patient age [26].…”

Metástasis cervical de carcinoma papilar tiroideo oculto

“…As a result, there has been controversy surrounding the need for therapy in these cases and how extensive this should be. 35 With regard to the extent of a thyroidectomy, Hay and cols., 35 33,50 These findings suggests that patients with palpable lymphadenopathy have a high risk of nodal recurEn lo que respecta al microcarcinoma papilar tiroideo, dado el desarrollo de las técnicas de diagnóstico por imagen y el uso de la punción aspiración con aguja fina, en los últimos tiempos ha aumentado el diagnóstico incidental de éstos y, con ello, ha aumentado también la controversia acerca de si precisa tratamiento y cual debe ser la extensión de éste. 35 En cuanto a la extensión de la tiroidectomía, Hay y cols, 35 en un estudio sobre 535 microcarcinomas papilares objetivaron un mayor porcentaje de recidivas locorregionales en aquellos sujetos sometidos a una lobectomía unilateral, respecto a los que se realizó una resección bilateral del tiroides (20 y 5% de recidivas a los 20 años, respectivamente), pero sin objetivar diferencias estadísticamente significativas entre la realización de tiroidectomía subtotal, casi total o total.…”

“…25,50 Incluso tras este, Wada y cols. 25 objetivaron un 16,7% de recidivas ganglionares, porcentaje similar al encontrado en carcinomas papilares de mayor tamaño.…”

“…25 objetivaron un 16,7% de recidivas ganglionares, porcentaje similar al encontrado en carcinomas papilares de mayor tamaño. 33,50 Este hallazgo sugiere que los pacientes con adenopatías palpables tienen un alto riesgo de recurrencia nodal independientemente del tamaño del carcinoma primario, por lo que el vaciamiento cervical debería guiarse por los mismos criterios. En el caso de microcarcinomas papilares tiroideos sin adenopatías palpables, el mismo estudio de Wada no evidencia disminución en el número de recidivas para el grupo de tratados con linfadenectomía cervical profiláctica.…”