Predictive Factors For Ipsilateral or Contralateral Central Lymph Node Metastasis in Unilateral Papillary Thyroid Carcinoma

Koo, Bon Seok; Choi, Eun Chang; Yoon, Yeo-Hoon; Kim, Dong-Hyun; Kim, Eung-Hyub; Lim, Young Chang

doi:10.1097/sla.0b013e3181a40919

Cited by 157 publications

(135 citation statements)

References 24 publications

Supporting

Mentioning

117

Contrasting

Unclassified

Order By: Relevance

“…The male gender has been consistently recognized as an independent risk factor of lymph node metastasis in thyroid carcinoma (14). Females are comparatively prone to thyroid Table III.…”

Section: Discussionmentioning

confidence: 99%

Outcome of papillary thyroid microcarcinoma: Study of 1,990 cases

Zhang

Wei

et al. 2015

Molecular and Clinical Oncology

View full text Add to dashboard Cite

Abstract. The present study examines the requirement of prophylactic neck node dissection in papillary thyroid microcarcinoma (PTMC) patients by analyzing high-risk factors of neck lymph node metastasis in PTMC. The clinical pathological data was a review of 1,990 patients diagnosed between January 2013 and January 2014. The data included information on patient gender, age, tumor size, multifocal, tumor pathological staging, bilateral thyroid cancer, the subtypes, BRAF V600E mutation, human telomerase reverse transcriptase (hTERT), extrathyroidal invasion and neck lymph node metastasis. The univariate analysis (χ 2 test) showed that a number of factors were significantly associated with neck lymph node metastasis in PTMC (P<0.05): Male gender, aged <45 years, extrathyroidal invasion, bilateral thyroid cancer, various subtypes (package type, follicular variant, diffuse sclerosing variant, eosinophils, tall cell and column variant), BRAF V600E mutation-positive, hTERT mutation-positive, pt3/4 and multifocality. The multivariate analysis (regression binary logistic) showed that the male gender, <45 years, tumor size >5 mm, extrathyroidal invasion, bilateral thyroid tumors, multifocality, BRAF V600E mutation-positive, hTERT mutation-positive and pt3/4 are associated with the neck lymph node metastasis in PTMC (P<0.05). These paired analysis results show that the subtypes of PTMC with tumor size >5 mm is more common than the specific types of PTMC in which the tumor is ≤5 mm in neck lymph node metastasis. The neck lymph node metastasis incidence of the >45 years age group patients without high-risk factors in PTMC is 8.13 and 6.80%, respectively. In conclusion, PTMC patients with high-risk factors only are recommended to undergo a prophylactic lymph node dissection.

show abstract

“…The male gender has been consistently recognized as an independent risk factor of lymph node metastasis in thyroid carcinoma (14). Females are comparatively prone to thyroid Table III.…”

Section: Discussionmentioning

confidence: 99%

Outcome of papillary thyroid microcarcinoma: Study of 1,990 cases

Zhang

Wei

et al. 2015

Molecular and Clinical Oncology

View full text Add to dashboard Cite

show abstract

“…Although a recent meta-analysis has found that those with clinically nodal negative (cN0) neck who undergo pCND might have reduced risk of LR than those who undergo TT-alone in the short-term, the former group has higher risks for temporary hypoparathyroidism and overall morbidity . Therefore, identification of predictive factors for occult CNM is crucial to reduce unnecessary pCND (Koo et al 2009, Hartl et al 2012, Zhang et al 2012, Zhao et al 2013.…”

Section: Introductionmentioning

confidence: 99%

Is BRAFV600E mutation a marker for central nodal metastasis in small papillary thyroid carcinoma?

Lang¹,

Chai²,

Cowling³

et al. 2014

Endocrine-Related Cancer

View full text Add to dashboard Cite

Utilizing BRAF V600E mutation as a marker may reduce unnecessary prophylactic central neck dissection (pCND) in clinically nodal negative (cN0) neck for small (%2 cm) classical papillary thyroid carcinoma (PTC). We aimed to assess whether BRAF is a significant independent predictor of occult central nodal metastasis (CNM) and its contribution to the overall prediction after adjusting for other significant preoperative clinical factors in small PTC. Primary tumor tissue (paraffin-embedded) from 845 patients with small classical cN0 PTC who underwent pCND was tested for BRAF mutation. Clinicopathologic factors were compared between those with and without BRAF. BRAF was evaluated to see if it was an independent factor for CNM. Prediction scores were generated using logistic regression models and their predictability was measured by the area under the ROC curve (AUC). : 5.18-20.88), and BRAF (OR: 1.65, 95% CI: 1.10-2.46) were significant independent predictors of CNM, while coexisting Hashimoto's thyroiditis (OR: 0.56, 95% CI: 0.40-0.80) was an independent protective factor. The AUC for prediction score based on tumor size and male sex was similar to that of prediction score based on tumor size, male sex, and BRAF status (0.68 vs 0.69, PZ0.60). Although BRAF was an independent predictor of CNM, knowing its status did not substantially improve the overall prediction. A simpler prediction score based on male sex and tumor size might be sufficient.

show abstract

“…The fact is that some 30-60% of clinically negative central necks will harbour metastatic lymph nodes (10,27,30). Some authors do not consider subclinical lymph node involvement as a risk factor for recurrence, because usually metastatic nodes are few in number and will be sterilized by routine radioidine ablation (37).…”

Section: Prophylactic Central Neck Dissectionmentioning

confidence: 99%

“…In some 5-10% of cases, N1b disease (lateral lymph node metastasis) may skip the central neck, usually in cases where the tumour is located in the upper poles of the thyroid (29). The most widely recognized pathological variable associated with central neck metastasis in advanced PTC is extrathyroidal invasion usually, but not always, associated with large tumours (28,30,31).…”

Section: How Often Is the Central Neck Compartment Involved In Non-mimentioning

confidence: 99%

THERAPY OF ENDOCRINE DISEASE: Central neck dissection: a step forward in the treatment of papillary thyroid cancer

Sitges‐Serra

Lorente

Mateu

et al. 2015

European Journal of Endocrinology

View full text Add to dashboard Cite

Since its introduction in the '70s and '80s, CND for papillary cancer is here to stay. Compartment VI should always be explored during surgery for papillary thyroid carcinoma (PTC) for obvious lymph node metastases. These can be easily spotted by an experienced surgeon or, eventually, by frozen section. No doubt, obvious nodal disease in the Delphian, paratracheal and subithsmic areas should be dissected in a comprehensive manner (therapeutic central neck dissection), avoiding the selective removal of suspicious nodes. Available evidence for routine prophylactic CND is not completely satisfactory. Our group's opinion, however, is that it reduces or even eliminates the need for repeat surgery in the central neck, better defines the extent (and stage) of the disease and provides a further argument against routine radioiodine ablation. Thus, PTC is becoming more and more a surgical disease that can be cured by optimized surgery alone in the majority of cases. Prophylactic CND, however, involves a higher risk for the parathyroid function and should be skilfully performed, preferably only on the same side as the primary tumour and preserving the cervical portion of the thymus.

show abstract

Predictive Factors For Ipsilateral or Contralateral Central Lymph Node Metastasis in Unilateral Papillary Thyroid Carcinoma

Cited by 157 publications

References 24 publications

Outcome of papillary thyroid microcarcinoma: Study of 1,990 cases

Outcome of papillary thyroid microcarcinoma: Study of 1,990 cases

Is BRAFV600E mutation a marker for central nodal metastasis in small papillary thyroid carcinoma?

THERAPY OF ENDOCRINE DISEASE: Central neck dissection: a step forward in the treatment of papillary thyroid cancer

Contact Info

Product

Resources

About