Risk Factors for Cervical Lymph Node Metastasis in Middle Eastern Papillary Thyroid Microcarcinoma

Parvathareddy, Sandeep Kumar; Siraj, Abdul K.; Annaiyappanaidu, Padmanaban; Siraj, Nabil; Al-Sobhi, Saif S.; Al‐Dayel, Fouad; Al‐Kuraya, Khawla S.

doi:10.3390/jcm11154613

Cited by 6 publications

(11 citation statements)

References 53 publications

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“…In this retrospective study, we analyzed data from 4872 patients with cN0 PTMC to investigate the risk factors for LLNM. The rate of occult LLNM was found to be 3.2%, which is consistent with previous studies (ranging from 3.7-7.5%) [6,12]. Previous studies have recognized multifocality as a risk factor for LNM in PTMC [17,18].…”

Section: Discussionsupporting

confidence: 90%

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A nomogram for predicting lateral lymph node metastasis in cN0 unifocal papillary thyroid microcarcinoma

Huang

Song

et al. 2023

Preprint

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Background Identifying risk factors for occult lateral LNM in PTMC can assist in determining the necessity of LND and other measures to reduce the risk of recurrence. This study aimed to establish a nomogram for predicting the probability of lateral lymph node metastasis (LLNM) in patients with cN0 unifocal papillary thyroid microcarcinoma (PTMC).Methods We retrospectively analyzed a total of 4872 patients with cN0 unifocal PTMC who were treated at our center from January 2013 to June 2018. Logistic regression tests were used to determine the risk factors for LLNM. A nomogram was constructed based on these risk factors.Results The rate of LLNM was 3.2%. Tumors located in the upper lobe (OR = 2.56, 95% CI 1.80–3.62; p < 0.001) and size greater than 7 mm (OR = 2.59, 95% CI 1.85–3.62; p < 0.001) had a 2.5-fold higher risk of LLNM than tumors in the lower or middle lobe and size less than or equal to 7 mm. Tumors with extrathyroidal extension (ETE) had a significantly higher risk of LLNM (OR = 1.41, 95% CI 1.01–1.99; p = 0.044). Having three or more central lymph node metastases (CLNMs) (OR = 5.84, 95% CI 3.83–8.93; p < 0.001) or having one or two CLNMs (OR = 2.91, 95% CI 1.93–4.42; p < 0.001) both had a higher risk of LLNM than having no CLNMs. A nomogram was developed based on these risk factors. The ROC curve for predicting LLNM showed that the AUC was 0.777, indicating a high degree of consistency.Conclusion Tumors located in the upper lobe, greater than 7 mm in size, ETE, and CLNMs, especially three or more, were independent risk factors for LLNM in cN0 unifocal PTMC. The nomogram based on these factors had favorable predictive value and consistency, but further prospective research is needed to validate these findings.

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Section: Discussionsupporting

confidence: 90%

“…For the lateral neck, the ATA recommends therapeutic lateral neck dissection (LND) for cN1b PTC [8]. The incidence of lateral LNM in PTMC has varied in previous studies, ranging from 3.7-44.5% [6,10,11,12]. Most studies include both palpable and nonpalpable lymph nodes when analyzing the incidence of lateral LNM [6].…”

Section: Introductionmentioning

confidence: 99%

A nomogram for predicting lateral lymph node metastasis in cN0 unifocal papillary thyroid microcarcinoma

Huang

Song

et al. 2023

Preprint

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“… 58 Bilaterality and gross extrathyroidal extension (ETE) were independent influencing factors of LNM in PTMC patients. 59 Calcification, 52 , 60 male, 50 , 53 , 61 and bilaterality 62 have been found to be risk factors for lymph node metastasis, however, similar results were not obtained in this study.…”

Section: Discussioncontrasting

confidence: 73%

Younger Than 55 Years Old and BRAF V600E Mutation are Risk Factors for Lymph Node Metastasis in Papillary Thyroid Carcinomas ≤1.0 cm but Not in >1.0 cm

Lai¹,

Gu²,

Yu³

et al. 2023

IJGM

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Background Studies on the relationship between BRAF V600E mutation and the clinicopathologic features of papillary thyroid carcinoma (PTC), risk of lymph node metastasis in papillary thyroid microcarcinoma (PTMC) have shown inconsistent results. Methods In this retrospective analysis, clinicopathological data of the patients were collected, and molecular testing was done for BRAF V600E mutation. PTC patients are divided into PTC≤1.0cm (PTMC) and PTC>1.0cm, and the relationship between BRAF V600E mutation and clinicopathologic features was analyzed respectively. Results Of the 520 PTC patients, 432 (83.1%) were female and 416 (80.0%) were <55 years old. BRAF V600E mutation was detected in 422 (81.2%) tumour samples of PTC. There was no significant difference in the frequency of BRAF V600E mutation between different age groups. There were 250 (48.1%) patients with PTMC and 270 (51.9%) patients with PTC>1.0cm. BRAF V600E mutation was significantly associated with bilateral cancer (23.0% vs 4.9%, P =0.005) and lymph node metastasis (61.7% vs 39.0%, P =0.009) in PTMC patients, while BRAF V600E mutation was significantly associated with bilateral cancer (24.9% vs 12.3%, P =0.048) in PTC>1.0cm patients. Logistic regression analysis showed that, after adjusting for gender, Hashimoto’s thyroiditis and calcification, we found that younger age (<55 years old) (OR: 2.384, 95% CI: 1.241–4.579, P =0.009) and BRAF V600E mutation (OR: 2.213, 95% CI: 1.085–4.512, P =0.029) were significantly associated with lymph node metastasis in PTMC, similar results were not obtained in PTC>1.0cm. Conclusion Younger age (<55 years old) and BRAF V600E mutation was independent risk factor for lymph node metastasis in PTMC.

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“…As far as we are aware, there haven't been many studies done on the risk factors for LLNM in cN0 PTMC patients, particularly those with sizable sample sizes from a single centre [6, 10,11,12]. In this retrospective analysis, we looked into the risk variables for LLNM using data from 4872 individuals with cN0 PTMC.…”

Section: Discussionmentioning

confidence: 99%

“…The ATA advises therapeutic lateral neck dissection (LND) for cN1b PTC for the lateral neck [8]. In earlier investigations, the prevalence of lateral LNM (LLNM) in PTMC ranged from 3.7 to 44.5% [6,10,11,12]. When analysing the incidence of lateral LNM, the majority of studies take both palpable and nonpalpable lymph nodes into account [6].…”

mentioning

confidence: 99%

A nomogram for lateral lymph nodes that have metastatic cN0 unifocal papillary thyroid microcarcinoma

Saad,

Farid,

Eraky

et al. 2023

Preprint

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Background The need for lateral neck dissection (LND) in papillary thyroid microcarcinoma (PTMC) might be better understood by identifying risk variables for occult lateral lymph node metastasis (LLNM). This study's goal was to create a nomogram for predicting the likelihood of LLNM in individuals with cN0 unifocal PTMC. Methods A total of 9744 patients with cN0 unifocal PTMC who had treatment at our facility between February 2013 and April 2020 were the subject of our retrospective analysis. The risk variables for LLNM were identified using logistic regression analysis, and a nomogram was created based on these risk factors. Results 3.2% of the population had LLNM. Compared to tumours in the lower or middle lobe with a size less than or equal to 7 mm, tumours in the upper lobe had a substantially increased risk of LLNM (odds ratio [OR] = 2.56, 95% confidence interval [CI] 1.80–3.62; p 0.001) and OR = 2.59, 95% CI 1.85–3.62. ETE tumours had a significantly increased probability of developing LLNM (OR = 1.41, 95% CI 1.01–1.99; p = 0.044). One or two central lymph node metastases (CLNMs) or three or more of them (OR = 5.84, 95% CI 3.83-8.93; p 0.001) increased the probability of LLNM in comparison to having none (OR = 2.91, 95% CI 1.93-4.42; p 0.001). The receiver operating characteristic (ROC) curve of a nomogram that took these risk factors into account showed an area under the curve (AUC) of 0.777, indicating a good level of predictive accuracy. Conclusion Three or more CLNMs, especially three or more, and upper lobe tumours larger than 7 mm in size were independent risk factors for LLNM in cN0 unifocal PTMC. Based on these variables, the nomogram showed good predictive value and consistency.

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Risk Factors for Cervical Lymph Node Metastasis in Middle Eastern Papillary Thyroid Microcarcinoma

Cited by 6 publications

References 53 publications

A nomogram for predicting lateral lymph node metastasis in cN0 unifocal papillary thyroid microcarcinoma

A nomogram for predicting lateral lymph node metastasis in cN0 unifocal papillary thyroid microcarcinoma

Younger Than 55 Years Old and BRAF V600E Mutation are Risk Factors for Lymph Node Metastasis in Papillary Thyroid Carcinomas ≤1.0 cm but Not in >1.0 cm

A nomogram for lateral lymph nodes that have metastatic cN0 unifocal papillary thyroid microcarcinoma

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