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

Abstract

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.

Risk Factors for Contralateral Occult Carcinoma in Patients With Unilateral Papillary Thyroid Carcinoma: A Retrospective Study and Meta-Analysis

“…It was reported that multifocality increases the risk of CLNM ( 44 ). However, the role of multifocality in LLNM remains a topic of debate ( 43 , 45 ). Our results showed that patients with CLNM have more contralateral occult PTC but no significant relationship between LLNM and contralateral occult PTC.…”

<p>Individualized Prediction Of Metastatic Involvement Of Lymph Nodes Posterior To The Right Recurrent Laryngeal Nerve In Papillary Thyroid Carcinoma</p>

“…In the right paratracheal basins, the superficial nodes anterior to the right recurrent laryngeal nerve were labeled as paratracheal lymph nodes in order to distinguish these from LN-prRLN12 The right central lymph nodes (rCLN) excluding the LN-prRLN refer to the group of Delphian, pretracheal, and paratracheal lymph nodes collectively. The surgical procedure was described in our previous study 16. After thyroid lobectomy, we subdivided the right central compartment into Delphian, pretracheal, paratracheal, and LN-prRLN groups depending on the anatomical position12 Four subgroups were removed and labeled sequentially, and then immediately sent for intraoperative frozen section examination.…”

Clinicopathological Profile of Thyroid Carcinomas: A 10-Year Experience in a Tertiary Care Institute

“…Thyroid cancers (TC) are the most MBSJHS; 6(1), 2020 important diseases of the thyroid gland. İt is the most prevailing malignant tumor of the endocrine system (Hu et al, 2018). İt constitutes approximately 1% of all human malignancies and is the main cause of mortality among endocrine tumor-related deaths (Are & Shaha, 2006) İn 2010, Jemal et al reported 44700 new cases of thyroid cancers per year, worldwide, and 1700 deaths annually due to thyroid cancer (Jemal, Siegel, Xu, & Ward, 2010) Annual increase of 5.3% in TC incidence was reported by Magreni et al in 2015(Magreni, Bann, Schubart, & Goldenberg, 2015.…”