Role of prophylactic central neck lymph node dissection for papillary thyroid carcinoma in the era of de-escalation

Abstract

It is now well established that the biology of cancer is influenced by not only malignant cells but also other components of the tumour microenvironment. Chronic inflammation and fibrosis have long been postulated to be involved in carcinogenesis. Chronic inflammation can promote tumorigenesis via growth factor/cytokine-mediated cellular proliferation, apoptotic resistance, immunosuppression; and free-radical-induced oxidative deoxyribonucleic acid damage. Fibrosis could cause a perturbation in the dynamics of the tumour microenvironment, potentially damaging the genome surveillance machinery of normal epithelial cells. In this review, we will provide an in-depth discussion of various diseases characterised by inflammation and fibrosis that have been associated with an increased risk of malignancy. In particular, we will present a comprehensive overview of the impact of alterations in stromal composition on tumorigenesis, induced as a consequence of inflammation and/or fibrosis. Strategies including the application of various therapeutic agents with stromal manipulation potential and targeted cancer screening for certain inflammatory diseases which can reduce the risk of cancer will also be discussed.

Risk factors and nomogram to predict skip metastasis in papillary thyroid carcinoma

“…The incidence of thyroid carcinoma has been increasing in these years. Papillary thyroid carcinoma (PTC) is the most common pathological type while the rate of cervical lymph node metastasis is 12–81% ( 1 , 2 ). The metastatic pathway of PTC is generally continuous: it firstly invades the central lymph node (CLN), then the ipsilateral lateral lymph node (LLN), and finally involves the contralateral LLN and mediastinal lymph node ( 3 , 4 ).…”

Update on current diagnosis and management of anaplastic thyroid carcinoma

“…The 5-year survival of a well-differentiated thyroid carcinoma exceeds 95%[ 7 ]. In contrast, the undifferentiated form, also called by a revised and better term, anaplastic carcinoma determined from World Health Organization classification[ 8 ], accounts for less than 0.2%[ 9 ] or as much as 1%-2% of all thyroid malignancies[ 10 , 11 ].…”