Prognostic values of clinical lymph node metastasis and macroscopic extrathyroid extension in papillary thyroid carcinoma [Review]

Ito, Yasuhiro; Miyauchi, Akira; Kihara, Minoru; Kobayashi, Kaoru; Miya, Akihiro

doi:10.1507/endocrj.ej14-0138

Cited by 35 publications

(32 citation statements)

References 36 publications

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“…• Clinical lymph node metastasis: not only the presence of lymph node metastasis is important, but the number and size of metastasis are also among determining prognostic factors [36].…”

Section: Categories Of Thyroid Malignanciesmentioning

confidence: 99%

“…• Extrathyroid extension: it is one of the most important prognostic factors for PTC [36]. Grossly signiicant extrathyroid extension based on intra-operative evidences is one of the most reliable prognostic factors.…”

Section: Papillary Thyroid Cancermentioning

confidence: 99%

“…Most of the recent studies have set the cut of at 3-4 cm according to prognosis of PTC patients [25,[27][28][29][30]35]. • Extrathyroid extension: it is one of the most important prognostic factors for PTC [36]. Grossly signiicant extrathyroid extension based on intra-operative evidences is one of the most reliable prognostic factors.…”

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confidence: 99%

See 2 more Smart Citations

Thyroid Cancers: Considerations, Classifications, and Managements

Khosravi¹,

Kouhi²,

Saeedi³

et al. 2017

Diagnosis and Management of Head and Neck Cancer

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Rapidly increasing trend of thyroid cancer incidence has turned this disease into a global concern. An estimated number of 64,300 new cases of thyroid cancer occurred in men and women in 2016, which represents 3.8% of all new cancer cases of USA (htps://seer. cancer.gov/statfacts/html/thyro.html). Thus, there is a high possibility for every physician to encounter a case of thyroid cancer during his/her professional lifetime. In this chapter, we clariied epidemiology, diferent categories, and new approaches toward diagnosis and management of thyroid cancer.Keywords: thyroid cancer, epidemiology, diferentiated thyroid cancer, undiferentiated thyroid cancer, thyroid nodule Detailed epidemiology of thyroid cancerAs the most common endocrine cancer and ifth most common cancer in women, thyroid cancer includes approximately 1-1.5% of all new cases of cancer diagnosed annually in the USA based on previous data [1][2][3]. Thyroid cancer is more prevalent among women and those with positive family history of thyroid disease. Some prior studies have reported a worldwide increasing trend for thyroid cancer incidence in recent decades [4]. Annual percent change (APC) is a commonly used indicator for the assessment of changes in incidence. Based on US National Cancer Institute's Surveillance, Epidemiology, and End Results (SEER) program, it has been reported 2.4% from 1980 to 1997 and 6.6% from 1997 to 2009 in both genders for thyroid cancer (data available at htp://seer.cancer.gov/statfacts/html/thyro.html).© 2017 The Author(s). Licensee InTech. This chapter is distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/3.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.According to [2009][2010][2011][2012][2013] data, the rate of new cases of thyroid cancer was 13.9 per 100,000 men and women per year (Figure 1). Table 1 summarizes number of new cases per 100,000 persons by race/ethnicity and sex. A recently published study on adolescent cancer incidence during 1975-2012 has reported a 2.12% increase for females and 1.59% for males between 15 and 19 years of age [5]. However, there is a study indicating that thyroid cancer incidence trend has slowed following release of American Thyroid Association (ATA) guideline in 2009 [6, 7]. It has been reported that overall thyroid cancer incidence had an increasing trend about 8% per year from 2000 to 2009. But APC showed a deceleration about 3% in men and 2.8% in women, which was conined to tumors less than 2.9 cm of size for women [7].Also, thyroid cancer-related mortality was estimated to consist 0.3% of all cancer-related deaths in 2016. A 5-year survival rate of 98.1% has been reported for thyroid cancer. Despite increasing trend of incidence, thyroid cancer mortality has a relatively stable rate about 0.5 cases per 100,000 persons both from 1973 to 2002 and 2009 to 2013 [8, 9].In conclusion, it seems that thyroid cancer has been following an ...

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“…• Clinical lymph node metastasis: not only the presence of lymph node metastasis is important, but the number and size of metastasis are also among determining prognostic factors [36].…”

Section: Categories Of Thyroid Malignanciesmentioning

confidence: 99%

Section: Papillary Thyroid Cancermentioning

confidence: 99%

See 1 more Smart Citation

Thyroid Cancers: Considerations, Classifications, and Managements

Khosravi¹,

Kouhi²,

Saeedi³

et al. 2017

Diagnosis and Management of Head and Neck Cancer

View full text Add to dashboard Cite

show abstract

“…It is important to emphasize that micro‐PTCs in this study were not incidental “occult” tumors just because they were detected by ultrasound in asymptomatic patients. The high rates of extrathyroidal extension to the fat and connective tissue and nodal disease attest to the justified treatment tactics that included surgery in view of the patients’ young age and the risk of rapid progression of tumors with such invasive characteristics …”

Section: Discussionmentioning

confidence: 99%

Histopathological analysis of papillary thyroid carcinoma detected during ultrasound screening examinations in Fukushima

et al. 2019

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Thyroid ultrasound screening of young residents in Fukushima Prefecture, Japan, showed a high detection rate of papillary thyroid carcinoma (PTC). Detailed morphological analysis of these tumors was not presented to date. This study sets out to evaluate changes in histopathological and invasive characteristics of Fukushima PTC with time after the nuclear accident of March 2011 in all available cases and in different age subgroups. Histological specimens of 115 PTCs from patients aged 18 years or younger at the time of the Fukushima Dai‐ichi Nuclear Power Plant accident, who underwent surgical resection at Fukushima Medical University during 2012‐2016, were reviewed. Patients were divided into those treated during the first 4 years after the accident (n = 78, shorter‐onset) or later (n = 37, longer‐onset). The whole group and 3 age subgroups: children (aged less than 15 years), adolescents (aged from 15 to less than 19 years), and young adults (aged from 19 years) at surgery were analyzed. No statistically significant time‐related changes in tumor structure or invasiveness were found in the whole group or in age‐matched subgroups. Statistically significant age‐related downtrend was observed for intrathyroid spread in the whole group of patients. The absence of temporal changes in tumor morphological characteristics and tumor invasiveness strongly suggests common etiology of the shorter‐ and longer‐onset Fukushima PTCs, which are unlikely related to the effect of exposure to very low doses of radiation.

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“…So we decided to perform this new analysis including only those patients with any T stage and relevant LN metastasis. It was shown that massive invasion (T4a or T4b) is one of the high-risk factors for disease-free survival in patients aged ≥50 years [41,42]. …”

Section: Discussionmentioning

confidence: 99%

Recombinant Human Thyroid-Stimulating Hormone-Aided Remnant Ablation Achieves a Response to Treatment Comparable to That with Thyroid Hormone Withdrawal in Patients with Clinically Relevant Lymph Node Metastases

2014

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It has already been shown that remnant ablation in patients with thyroid cancer and lymph node (LN) metastases has similar results when patients are prepared after recombinant human thyroid-stimulating hormone (rhTSH) therapy or thyroid hormone withdrawal (THW). Due to the current changes in the risk-of-recurrence classifications, we decided to evaluate the initial response to treatment and the outcome at medium-term follow-up in 40 consecutive patients with clinically relevant lymph nodes who received radioiodine remnant ablation after rhTSH therapy (n = 20) or THW (n = 20). Each patient received either 100 or 150 mCi 131-I for ablation based on TNM status, and the mean amounts of 131-I used in the 2 groups were not significantly different. An excellent response to treatment was observed in 45% of the patients prepared after rhTSH therapy compared to 20% of those prepared after THW (p = 0.08). Three patients (2 in the THW group and 1 in the rhTSH group) who had N1a in the initial surgery presented with structural persistence as an initial response to treatment. One patient in the THW group had a follow-up of the persistent disease with no surgical treatment, and 2 others received a lateral LN dissection. When the status at final follow-up was considered (median follow-up 3.3 years, range 3-4.2), 60% of the patients ablated after rhTSH therapy were considered with no evidence of disease, compared to 30% of those who underwent THW. The frequency of structural persistence (metastatic LN) was similar in the 2 groups (15 vs. 25%), and the distribution of the responses at final follow-up was not statistically significantly different (p = 0.12). We conclude that preparation after rhTSH therapy seems to be as effective as after THW for patients with clinically relevant LN metastases.

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Prognostic values of clinical lymph node metastasis and macroscopic extrathyroid extension in papillary thyroid carcinoma [Review]

Cited by 35 publications

References 36 publications

Thyroid Cancers: Considerations, Classifications, and Managements

Thyroid Cancers: Considerations, Classifications, and Managements

Histopathological analysis of papillary thyroid carcinoma detected during ultrasound screening examinations in Fukushima

Recombinant Human Thyroid-Stimulating Hormone-Aided Remnant Ablation Achieves a Response to Treatment Comparable to That with Thyroid Hormone Withdrawal in Patients with Clinically Relevant Lymph Node Metastases

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