Risk factors analyses for lateral lymph node metastases in papillary thyroid carcinomas: a retrospective study of 356 patients

Nie, Xilin; Tan, Zhuo; Ge, Minghua; Jiang, Liehao; Wang, Jiafeng; Zheng, Chuanming

doi:10.1590/2359-3997000000218

Cited by 24 publications

(28 citation statements)

References 37 publications

(39 reference statements)

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“…Previous studies found that male gender was associated with CLN metastasis, but was not associated with LLN metastasis [ 13 , 14 ]. In the present study, age was not associated with risk of LLN metastasis, which is in agreement with two previous studies [ 13 , 15 ].…”

Section: Discussionsupporting

confidence: 94%

“…Many studies have shown that lymph node metastasis is associated with tumor size. Nie et al [ 15 ] suggested that a tumor diameter > 1.5 cm is an independent risk factor for LLN metastasis. However, another study suggested a cut-off point of 2 cm [ 13 ], which is in accord with the results of the current study.…”

Section: Discussionmentioning

confidence: 99%

“…However, bilateral lesions were not a potential risk factor. Nie et al [ 15 ] suggested that multifocality and bilateral were not risk factors for lymph node metastasis.…”

Section: Discussionmentioning

confidence: 99%

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Risk factors of lateral lymph node metastasis in cN0 papillary thyroid carcinoma

Zhou

et al. 2018

World J Surg Onc

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BackgroundCervical lymph node metastasis of papillary thyroid carcinoma (PTC) is common. However, whether undergoing prophylactic central lymph node (CLN) dissection or lateral lymph node (LLN) dissections to prevent metastasis is still controversial. This study aimed to retrospectively investigate the risk factors of LLN metastasis in clinical lymph node-negative (cN0) PTC patients.MethodsWe retrospectively studied 783 lymph node-negative (cN0) PTC patients who underwent total thyroidectomy plus CLN dissection and LLN dissection.ResultsThe rates of CLN and LLN metastases were 68.2 and 47.4%, respectively. Large tumor size (> 20 mm) had a fourfold higher risk of LLN metastasis compared with small tumor size (≤ 20 mm; OR = 4.082, 95% CI 2.646–6.289; P = 0.001). Patients with tumor in the upper lobe had ~ 3-fold higher risk of LLN metastasis compared with patients with tumor in other locations (OR = 2.874, 95% CI 1.916–4.310; P = 0.001). Multifocality and extrathyroidal extension indicated a twofold higher risk of LLN metastasis. Having ≥ 2 CLN metastases dramatically increased the risk of LLN metastasis, compared with those with < 2 CLN metastases (OR = 6.536, 95% CI 4.630–9.259; P = 0.001).ConclusionsLarge tumor size (> 20 mm), tumor located in the upper lobe, multifocality, extrathyroidal extension, and ≥ 2 CLN metastases may increase the risk of LLN metastasis in cN0 PTC patients.

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Section: Discussionsupporting

confidence: 94%

Section: Discussionmentioning

confidence: 99%

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Risk factors of lateral lymph node metastasis in cN0 papillary thyroid carcinoma

Zhou

et al. 2018

World J Surg Onc

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“…There is evidence showing that some gray scale features of US has a close relationship with neck LN metastasis of PTC (19)(20)(21). However, the diagnosis varies greatly among different US physicians due to the considerable subjectivity of the understanding and application of diagnostic criteria.…”

Section: Introductionmentioning

confidence: 99%

An Ultrasound Radiomics Nomogram for Preoperative Prediction of Central Neck Lymph Node Metastasis in Papillary Thyroid Carcinoma

et al. 2020

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This study aimed to establish and validate an ultrasound radiomics nomogram for the preoperative prediction of central lymph node (LN) metastasis in patients with papillary thyroid carcinoma (PTC). Patients and Methods: The prediction model was developed in 609 patients with clinicopathologically confirmed unifocal PTC who received ultrasonography between Jan 2018 and June 2018. Radiomic features were extracted after the ultrasonography of PTC. Lasso regression model was used for data dimensionality reduction, feature selection, and radiomics signature building. The predicting model was established based on the multivariable logistic regression analysis in which the radiomics signature, ultrasonography-reported LN status, and independent clinicopathologic risk factors were incorporated, and finally a radiomics nomogram was established. The performance of the nomogram was assessed with respect to the discrimination and consistence. An independent validation was performed in 326 consecutive patients from July 2018 to Sep 2018. Results: The radiomics signature consisted of 23 selected features and was significantly associated with LN status in both primary and validation cohorts. The independent predictors in the radiomics nomogram included the radiomics signature, age, TG level, TPOAB level, and ultrasonography-reported LN status. The model showed good discrimination and consistence in both cohorts: C-index of 0.816 (95% CI, 0.808-0.824) in the primary cohort and 0.858 (95% CI, 0.849-0.867) in the validation cohort. The area under receiver operating curve was 0.858. In the validation cohort, the accuracy, sensitivity, specificity and AUC of this model were 0.812, 0.816, 0.810, and 0.858 (95% CI, 0.785-0.930), respectively. Decision curve analysis indicated the radiomics nomogram was clinically useful. Conclusion: This study presents a convenient, clinically useful ultrasound radiomics nomogram that can be used for the pre-operative individualized prediction of central LN metastasis in patients with PTC.

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“…The patient sex, age at the time of diagnosis, tumor size, nodal status, extra thyroid extension, distant metastasis, operative procedure, and histopathological pattern, are prognostic factors associated with differentiated thyroid cancer. Many researchers showed that age, tumor size, ETE and distant metastasis, were the most significant prognostic factors [27] [28].…”

Section: Discussionmentioning

confidence: 99%

The Relationship of Age and Clinicopathologic Pattern to the Aggressiveness of Thyroid Cancer

Albalawi¹

2018

JCT

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Objective: To study the relation of age and clinicopathologic pattern to the aggressiveness of thyroid cancer cases and the treatment results of patients from western region of Saudi Arabia with differentiated thyroid carcinoma referred for treatment in King Abdulaziz Hospital and Oncology Center, Jeddah, Saudi Arabia. Methods: Retrospective review of 174 patients with differentiated thyroid carcinoma and analysis of the clinicopathologic characteristics, age correlation to different risk factors, treatment protocol and results were performed. Results: Analysis of the clinicopathologic pattern showed no statistically significant difference between patients in the different age groups except for extrathyroid extension and lymph node involvement. Patients older than 45 years had a statistically significant lower incidence of nodal involvement and a higher rate of extrathyroid extension (<0.02). In this study, we used a high dose method (Radioiodine-131 dose 75 -100 mCi) for thyroid remnant ablation after thyroidectomy (total or near total) in 134 patients. An Iodine-131 dose of 200 mCi was used in 8 patients with distant metastases. In 24 patients with radioiodine-avid cervical lymph nodes and six patients with a gross residual tumor, an Iodine-131 dose of 150 mCi was used. For the whole study group, the 5-year overall survival and disease-free survival were 96% and 88%. Conclusion: Despite the fact that differentiated thyroid carcinoma is among the most curable cancer some patients are still at high risk for recurrent and increased mortality.

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Risk factors analyses for lateral lymph node metastases in papillary thyroid carcinomas: a retrospective study of 356 patients

Cited by 24 publications

References 37 publications

Risk factors of lateral lymph node metastasis in cN0 papillary thyroid carcinoma

Risk factors of lateral lymph node metastasis in cN0 papillary thyroid carcinoma

An Ultrasound Radiomics Nomogram for Preoperative Prediction of Central Neck Lymph Node Metastasis in Papillary Thyroid Carcinoma

The Relationship of Age and Clinicopathologic Pattern to the Aggressiveness of Thyroid Cancer

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