Possible prediction of patterns of cervical lymph node spread based on primary tumor location in papillary thyroid carcinomas

Sancaktar, Mehmet Eser; Saylam, Güleser; Öcal, Bülent; Uluat, Ahmet; Bayır, Ömer; Çakal, Erman; Korkmaz, Hakan

doi:10.3906/sag-1807-79

Cited by 3 publications

(4 citation statements)

References 20 publications

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“…CLNM, which was the main contributor among all patients in our study, was observed at a lower rate in the upper pole group compared with the non-upper pole group. This result further indicates that there might be a direct lymph pathway from the upper pole of the thyroid to the lateral compartments, consistent with a previous report [ 31 ].…”

Section: Discussionsupporting

confidence: 93%

PTC located in the upper pole is more prone to lateral lymph node metastasis and skip metastasis

Dou

Chen

et al. 2020

World J Surg Onc

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Background Lateral lymph node metastasis (LLNM) is very common in papillary thyroid carcinoma (PTC). The influence of tumour location on LLNM remains controversial. The purpose of this study was to reveal the association between PTC tumours located in the upper pole and LLNM. Methods We reviewed a total of 1773 PTC patients who underwent total thyroidectomy with central and lateral lymph node dissection between 2013 and 2018. Patients were divided into two groups according to tumour location. Univariate and multivariate analyses were performed to identify risk factors associated with LLNM and “skip metastasis”. Results In the upper pole group, LLNM and skip metastasis were significantly likely to occur. Multivariate analysis showed that tumours located in the upper pole, male sex, extrathyroidal extension (ETE), central lymph node metastasis (CLNM) and tumour size were independent risk factors for LLNM, with odds ratios ([ORs], 95% confidence intervals [CIs]) of 2.136 (1.707–2.672), 1.486 (1.184–1.867), 1.332 (1.031–1.72), 4.172 (3.279–5.308) and 2.496 (1.844–3.380), respectively. Skip metastasis was significantly associated with the primary tumour location in the upper pole and age > 55 years, with ORs of 4.295 (2.885–6.395) and 2.354 (1.522–3.640), respectively. Conclusions In our opinion, papillary thyroid tumours located in the upper pole may have an exclusive drainage pathway to the lateral lymph nodes. When the tumour is located in the upper pole, lateral neck dissection should be evaluated meticulously.

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Section: Discussionsupporting

confidence: 93%

PTC located in the upper pole is more prone to lateral lymph node metastasis and skip metastasis

Dou

Chen

et al. 2020

World J Surg Onc

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“…In addition, an increasing number of studies have reported that upper tumor location was related with LLNM in PTC and PTMC no matter whether central neck had metastatic lymph node or not (11,20,43,44). The presence of a direct lymphatic drainage from the upper third of thyroid to the neck may explain this finding (44,45).…”

Section: Discussionmentioning

confidence: 98%

Clinical and Ultrasonic Risk Factors for Lateral Lymph Node Metastasis in Papillary Thyroid Microcarcinoma: A Systematic Review and Meta-Analysis

et al. 2020

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Background: Clinical and ultrasonic risk factors for lateral lymph node metastasis (LLNM) in papillary thyroid microcarcinoma (PTMC) are not well-defined. Herein, a systematic review and meta-analysis was conducted to investigate clinicopathologic and ultrasonic risk features for LLNM in PTMC. Methods: A systematic search of electronic databases (PubMed, Embase, Cochrane Library, and Web of Science) for studies published until April 2019 was performed. Case-control studies and randomized controlled trials that studied clinical and ultrasonic risk factors of LLNM in PTMC were included. Results: Fourteen studies (all retrospective studies) involving 43,750 patients met final inclusion criteria. From the pooled analyses, younger age<45 (OR, 1.

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“…Some studies have reported that the risk of cervical LNM was associated with tumor location in PTC. [23][24][25][26] However, there is no research regarding the effect of tumor location on the risk of bilateral CLNM. One study showed that isthmus tumors were more likely to have CLNM than tumors in other locations.…”

Section: Discussionmentioning

confidence: 99%

“…26 Other studies demonstrated that the risk of lateral neck LNM was higher in upper pole tumors, and the risk of CLNM was much lower. [23][24][25] It is not clear why near-isthmus tumors are at a higher risk of bilateral CLNM. The possible mechanisms could be that PTC located in the near isthmus has similar characteristics as those located in the isthmus.…”

Section: Discussionmentioning

confidence: 99%

Effect of Tumor Location on the Risk of Bilateral Central Lymph Node Metastasis in Unilateral 1-4 cm Papillary Thyroid Carcinoma

Liu

Chen

et al. 2021

CMAR

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Purpose: Papillary thyroid carcinoma (PTC) has a high incidence of lymph node metastasis (LNM). Our aim was to determine whether tumor location is a useful feature to predict bilateral central lymph node metastasis (CLNM) in unilateral 1-4 cm PTC. Patients and Methods: Data on unilateral 1-4 cm PTC patients from 2016 to 2019 were collected retrospectively. The clinical and pathological characteristics of the tumors and lymph nodes were analyzed statistically. Results: The mean patient age was 49.1±12.3 (23-73) years, and the majority were women (n=1334, 75.4%). A total of 1767 patients were analyzed, and 256 (14.5%) had bilateral CLNM. Tumor location was an independent risk factor in predicting bilateral CLNM (p<0.001). The odds of bilateral CLNM were the highest in the near isthmus (OR 6.452, p<0.001). In a multivariate regression model adjusting for other risk factors, near-isthmus tumors had the highest risk of bilateral CLNM (OR 7.319, 95% CI: 3.844-13.933, p<0.001), followed by lower lobe tumors (OR 2.338, 95% CI: 1.315-4.155, p=0.004) and middle lobe tumors (OR 1.845, 95% CI: 1.035-3.291, p=0.038), compared to upper lobe tumors. Conclusion:Tumor location is an independent risk factor in predicting the risk of bilateral CLNM. Near-isthmus tumors carry the highest risk of bilateral CLNM.

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Possible prediction of patterns of cervical lymph node spread based on primary tumor location in papillary thyroid carcinomas

Cited by 3 publications

References 20 publications

PTC located in the upper pole is more prone to lateral lymph node metastasis and skip metastasis

PTC located in the upper pole is more prone to lateral lymph node metastasis and skip metastasis

Clinical and Ultrasonic Risk Factors for Lateral Lymph Node Metastasis in Papillary Thyroid Microcarcinoma: A Systematic Review and Meta-Analysis

Effect of Tumor Location on the Risk of Bilateral Central Lymph Node Metastasis in Unilateral 1-4 cm Papillary Thyroid Carcinoma

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