Risk Factors for Neck Nodal Metastasis in Papillary Thyroid Microcarcinoma: A Study of 1066 Patients

Zhang, Ling; Wei, Wen Jun; Ji, Qing; Zhu, Yong; Wang, Zhuo Ying; Wang, Yu; Huang, Chenlu; Shen, Qiang; Li, Duan Shu; Wu, Yi Long

doi:10.1210/jc.2011-1546

Cited by 268 publications

(250 citation statements)

References 36 publications

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“…The incidence of CLNM in the present study was 40.6% (n=159), which is consistent with previous studies (21,22). Statistical analyses performed between the CLNM-positive and -negative groups in the present study included eight clinicopathological parameters.…”

Section: Discussionsupporting

confidence: 92%

Prediction of central lymph node metastasis in 392 patients with cervical lymph node-negative papillary thyroid carcinoma in Eastern China

et al. 2015

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Abstract. Central lymph node metastasis (CLNM) is common in papillary thyroid microcarcinoma (PTMC). The aim of the present study was to investigate the risk factors associated with CLNM in clinical lateral cervical lymph node-negative (cN0) PTMC in Eastern China. A total of 392 patients with confirmed PTMC by histological examination who underwent thyroidectomy and central neck lymph node dissection (CND) between May 2011 and October 2012 at the First Affiliated Hospital of Wenzhou Medical University (Wenzhou, China) were enrolled. The clinicopathological and ultrasonographic data from the patients were analyzed retrospectively. A scoring system was developed on the basis of independent predictive factors for CLNM. Male gender, age <45 years, maximum tumor diameter >5 mm, lower lobe location, multifocal carcinoma with total tumor diameter >10 mm and extracapsular spread were independent predictive factors for CLNM according to logistic regression analysis. The clinicopathological score was statistically significant, with an index point ≥2 indicating CLNM with 86.2% sensitivity and 70.4% specificity. The findings of the present study indicate that CND may be recommended to be routinely performed when the clinicopathological index point ≥2.

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Section: Discussionsupporting

confidence: 92%

Prediction of central lymph node metastasis in 392 patients with cervical lymph node-negative papillary thyroid carcinoma in Eastern China

et al. 2015

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“…(14,15) In this study, male sex was independently predictive of CLNM, in agreement with previous reports. Although the incidence of PTMC was higher among females in an epidemiological survey, males require specialized neck examinations to enable the early detection of thyroid tumors.…”

Section: Discussionsupporting

confidence: 93%

Factors Influencing Central Neck Lymph Node Metastasis in Patients with Papillary Thyroid Microcarcinoma

Kim

2016

Korean J Endocr Surg

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Purpose: A papillary thyroid microcarcinoma (PTMC) measures 1 cm or less in diameter. The diagnosis, and thus the apparent incidence, of PTMC has recently increased owing to an increase in the detection of subclinical small and low-risk carcinomas with ultrasonography and fine needle aspiration cytology. However, central neck lymph node metastasis (CLNM) can occur in patients with PTMC. We evaluated the factors influencing CLNM in patients with PTMC. Methods: We reviewed medical records including clinical information and pathologic reports, and analyzed 622 patients with PTMC who underwent thyroid surgery from January 2002 to December 2012. Results: CLNM was detected in 119 patients (19.1%) of the 622 with PTMC. Lymph node metastasis occurred more frequently in males (P=0.025), and those with bilateral tumors (P=0.016), more than two tumors (P=0.035), tumor size greater than 5 mm (P＜0.001), and lymphovascular invasion (P=0.024). There were no statistically significant differences in age and capsular invasion. Multivariate analysis showed that significant factors affecting lymph node metastasis included age at operation (odds ratio [OR]

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“…In general, PTMC is more prevalent in women than in men; however, studies reported that CLNM occurs more frequently in men (22,23). In this study, univariate analysis showed no statistical significance between sex and CLNM.…”

Section: Discussioncontrasting

confidence: 73%

Predictive Factors for Central Neck Lymph Node Metastasis in Patients with Papillary Thyroid Microcarcinoma without Suspicious Metastasis by Preoperative Ultrasonography

Jeong

Kim

2017

J Endocr Surg

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Purpose: We aimed to determine the influencing factors for central neck lymph node metastasis (CLNM) in papillary thyroid microcarcinoma (PTMC) without clinical evidence of metastasis on preoperative ultrasonography. Methods: We retrospectively analyzed 625 patients with PTMC who underwent thyroid surgery at Chosun University Hospital from January 2002 to December 2012. A total of 575 patients who had no evidence of lymph node metastasis by preoperative ultrasonography were included in the study. Medical records, including clinical information and pathologic report, were reviewed. Results: Central lymph node metastasis was found in 81 (14.1%) out of 575 patients. Results of univariate analysis indicated that lymph node metastasis occurred frequently in patients with more than 0.5 cm largest tumor size by preoperative sonography and pathologic reports (P=0.048 and P=0.001, respectively) and lymphovascular invasion (LVI) (P<0.001). Multivariate analysis revealed that sex (female vs. male), pathologic tumor size (0.5-1.0 cm vs. <0.5 cm), and LVI (yes vs. no) were significantly associated with lymph node metastasis (odds ratio [OR], 0.498, 95% confidence interval [CI], P=0.047; OR, 2.450, 95% CI, P=0.005; and OR, 24.954, 95% CI, P=0.007, respectively). Conclusion: Male sex, large tumor size (≥0.5 cm), and LVI were the risk factors for CLNM in patients with PTMC without clinical evidence of node metastasis. Prophylactic central neck lymph node dissection (CLND) might be required in these cases of PTMC.

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Risk Factors for Neck Nodal Metastasis in Papillary Thyroid Microcarcinoma: A Study of 1066 Patients

Cited by 268 publications

References 36 publications

Prediction of central lymph node metastasis in 392 patients with cervical lymph node-negative papillary thyroid carcinoma in Eastern China

Prediction of central lymph node metastasis in 392 patients with cervical lymph node-negative papillary thyroid carcinoma in Eastern China

Factors Influencing Central Neck Lymph Node Metastasis in Patients with Papillary Thyroid Microcarcinoma

Predictive Factors for Central Neck Lymph Node Metastasis in Patients with Papillary Thyroid Microcarcinoma without Suspicious Metastasis by Preoperative Ultrasonography

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