Predictive value of ipsilateral central lymph node metastasis for contralateral central lymph node metastasis in patients with thyroid cancer: Systematic review and meta‐analysis

Kim, Do Hyun; Kim, Geun‐Jeon; Kim, Sung Won; Hwang, Se Hwan

doi:10.1002/hed.26787

Cited by 9 publications

(6 citation statements)

References 37 publications

(93 reference statements)

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“…This was suggested also in a previous similar metaanalyses study which showed similar promising outcomes for prophylactic central neck dissection following total thyroidectomy in improving the haemorrhage and reducing the surgical site wound infection. [56][57][58][59] Well-conducted randomised controlled trials are needed to assess these factors and the combination of different ages, ethnicity, and other variants of subjects; because our meta-analysis study could not answer whether different ages, ethnicity, and gender are related to the results.…”

Section: Discussionmentioning

confidence: 99%

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Effect of prophylactic central neck dissection following total thyroidectomy on surgical site wound infection, hematoma, and haemorrhage in subjects with clinically node‐negative papillary thyroid carcinoma: A meta‐analysis

Jin

Liu

Wang

et al. 2022

International Wound Journal

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We performed a meta-analysis to evaluate the effect of prophylactic central neck dissection following total thyroidectomy on surgical site wound infection, hematoma, and haemorrhage in subjects with clinically node-negative papillary thyroid carcinoma. A systematic literature search up to April 2022 was performed and 3517 subjects with clinically node-negative papillary thyroid carcinoma at the baseline of the studies; 1503 of them were treated with prophylactic central neck dissection following total thyroidectomy, and 2014 were using total thyroidectomy. Odds ratio (OR) with 95% confidence intervals (CIs) were calculated to assess the effect of prophylactic central neck dissection following total thyroidectomy on surgical site wound infection, hematoma, and haemorrhage in subjects with clinically node-negative papillary thyroid carcinoma using the dichotomous method with a random or fixedeffect model. The prophylactic central neck dissection following total thyroidectomy subjects had a significantly lower surgical site wound infection (OR, 0.40; 95% CI, 0.20-0.78, P = .007) in subjects with clinically node-negative papillary thyroid carcinoma compared with total thyroidectomy. However, prophylactic central neck dissection following total thyroidectomy did not show any significant difference in hematoma (OR, 0.08; 95% CI, 0.43-2.71, P = .87), and haemorrhage (OR, 0.72; 95% CI, 0.26-1.97, P = .52) compared with total thyroidectomy in subjects with clinically node-negative papillary thyroid carcinoma. The prophylactic central neck dissection following total thyroidectomy subjects had a significantly higher surgical site wound infection, and no significant difference in hematoma, and haemorrhage compared with total thyroidectomy in subjects with clinically node-negative papillary thyroid carcinoma. The analysis of outcomes should be with caution because of the low number of studies in certain comparisons.

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Section: Discussionmentioning

confidence: 99%

“…This was suggested also in a previous similar meta‐analyses study which showed similar promising outcomes for prophylactic central neck dissection following total thyroidectomy in improving the haemorrhage and reducing the surgical site wound infection. 56 , 57 , 58 , 59 …”

Section: Discussionmentioning

confidence: 99%

Effect of prophylactic central neck dissection following total thyroidectomy on surgical site wound infection, hematoma, and haemorrhage in subjects with clinically node‐negative papillary thyroid carcinoma: A meta‐analysis

Jin

Liu

Wang

et al. 2022

International Wound Journal

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“…Kim et al suggested that ipsilateral central lymphatic metastasis could predict contralateral central lymphatic metastasis. In addition, they demonstrated a strong association between contralateral central lymphatic metastasis and speci c clinicopathological features, including young male, multifocality, external thyroid extension and tumor size [27].However, for patients of PTC with CN1b, total thyroidectomy plus lateral cervical lymph node dissection is generally performed. Few studies have reported whether the contralateral central lymph node dissection is necessary for patients with unilateral PTC with N1b.In our study, patients with ipsilateral central lymphatic metastasis rate is 78.2.…”

Section: Discussionmentioning

confidence: 99%

Patterns of lymph node metastasis in Level IIB and Contralateral Level VI for Papillary Thyroid Carcinoma with pN1b and Safety of low collar extended incision for neck dissection in Level II

Ning

Zeng

Zhou

et al. 2022

Preprint

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Objective To explore relevant clinical factors of Level IIB and contralateral Level VI lymph node metastasis and evaluate the safety of low -collar extended incision(LCEI) for lymph node dissection in level II for papillary thyroid carcinoma(PTC) with pN1b. Method A retrospective analysis was performed on 218 patients with PTC with pN1b who were treated by surgery in the Head and Neck Surgery Center of Sichuan Cancer Hospital from September 2021 to May 2022.The data on age, gender, body mass index(BMI), tumor location, maximum tumor diameter, multifocality, Braf gene, T staging, surgical incision style and lymph node metastasis in each cervical subregion were collected. The chi-square test were used for comparative analysis of relevant factors. All statistical analysis was completed by SPSS.24 software. Result Each subgroup on gender, age, BMI, multifocality ,tumor location, extrathyroidal extension, Braf gene, lymphatic metastasis in level III, level IV and level V had no statistical difference in the positive rate of lymph node metastasis in level IIB(P > 0.05).In contrast, patients with bilateral lateral cervical lymphatic metastasis were more likely to have lymphatic metastasis in level IIB than those with unilateral lateral cervical lymphatic metastasis, with a statistically significant difference (P = 0.000). Besides, lymph node metastasis in level IIA was significantly associated with lymph node metastasis in level IIB (P = 0.001). The LCEI group had the similar lymphatic metastasis number and lymphatic metastasis rate in both level IIA and level IIB with the L-shaped incision group(P > 0.05).Patients with ipsilateral central lymphatic metastasis had 86 cases(78.2%). While patients with contralateral central lymphatic metastasis accounted for 56.4%.The contralateral central lymphatic metastasis rate was not correlated with age, BMI, multifocality, tumor invasion and ipsilateral central lymphatic metastasis, and there was no statistical difference (P > 0.05). The contralateral central lymphatic metastasis in males was slightly higher than that in females, and the difference was statistically significant (68.2%vs48.5%, P = 0.041). Conclusion Lymphatic metastasis in Level IIA was an independent predictor of lymphatic metastasis in Level IIB. When bilateral lateral cervical lymphatic metastasis or lymph node metastasis of level IIA are found, lymph node dissection in level IIB is strongly recommended.When unilateral lateral cervical lymphatic metastasis and lymphatic metastasis in level IIA is negative, lymph node dissection in level IIB may be performed as appropriate on the premise of no damage to the accessory nerve.LCEI is safe and effective for lymph node dissection in Level II. When the tumor is located in unilateral lobe, attention should be paid to the contralateral central lymph node dissection because of the high lymphatic metastasis rate.

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“…Regional lymph node metastases develop in 20-90% of patients with PTC, with the cervical central compartment, or level VI node, being the primary zone of lymphatic involvement (5).…”

Section: Introductionmentioning

confidence: 99%

Significance and predictive value of Delphian lymph node in papillary thyroid carcinoma

yin,

Wu,

Wang

2023

Preprint

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Backgroud: Delphian lymph node metastasis (DLN) is common in papillary thyroid cancer(PTC). However, there have been limited studies that have specifically examined the clinicopathological characteristics of DLN metastasis in PTC. We objected to investigate the incidence, risk factors and predictive value of DLN in papillary thyroid carcinoma. Methods: Clinical pathological features and metastatic risks were statistically analyzed by reviewing 1837 patients with papillary thyroid carcinoma, who received their first operation in our department between January 2018 and July 2021. Results: Of the 1837 patients included in the study, DLN was detected in 925 patients (50.7%), 409 patients (22.3%) had confirmed DLN metastasis. In univariate analysis, DLN metastasis was correlated with age(≥55y), tumor size(≥1cm）, bilateral cancer, mulifocality, tumor location(isthmus cancer), central lymph node metastasis(CLNM) and later lymph node metastasis(LLNM). However, it was not correlated with sex distribution, tumor size, thyroiditis, thyroid stimulating hormone(TSH) level and BRAF mutation. Multivariate analysis showed that CLNM(p=0.03), LLNM(p=0.025)，bilateral cancer and tumor location(p=0.017) were independent risk factors of DLN metastasis. DLN involvement was mildly predictive of CLNM(sensitivity=29.76%, specificity=87.06%, positive predictive values=74.08%, negative predictive values =49.93%, positive likelihood ratio=2.30, negative likelihood ratio=0.81), moderately predictive of LLNM(sensitivity=49.36%, specificity=85.01%, positive predictive values=46.94%, negative predictive values =86.20%, positive likelihood ratio=3.29, negative likelihood ratio=0.60). Conclusions: Bilateral cancer, CLNM, LLNM and isthmus cancer were independent risk factors of DLN metastasis. DLN metastasis could be used as a predictor of central and lateral lymph node metastasis. Positive DLN should be an alert signal to careful evaluate central and lateral lymph node in thyreoidectomy.

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Predictive value of ipsilateral central lymph node metastasis for contralateral central lymph node metastasis in patients with thyroid cancer: Systematic review and meta‐analysis

Cited by 9 publications

References 37 publications

Effect of prophylactic central neck dissection following total thyroidectomy on surgical site wound infection, hematoma, and haemorrhage in subjects with clinically node‐negative papillary thyroid carcinoma: A meta‐analysis

Effect of prophylactic central neck dissection following total thyroidectomy on surgical site wound infection, hematoma, and haemorrhage in subjects with clinically node‐negative papillary thyroid carcinoma: A meta‐analysis

Patterns of lymph node metastasis in Level IIB and Contralateral Level VI for Papillary Thyroid Carcinoma with pN1b and Safety of low collar extended incision for neck dissection in Level II

Significance and predictive value of Delphian lymph node in papillary thyroid carcinoma

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