Skip metastasis in papillary thyroid carcinoma is difficult to predict in clinical practice

Nie, Xilin; Tan, Zhou; Ge, Minghua

doi:10.1186/s12885-017-3698-2

Cited by 42 publications

(63 citation statements)

References 43 publications

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“…4,9,10 The incidence rate of skip metastasis ranges from 6.8% to 27.8% in PTC with LLNM. 15,20 In our study, skip metastasis was present in 62 out of 256 patients with LLNM (24.2%), which is a higher rate than in most other studies. The reason may be that all patients enrolled had PTMC, which is considered a risk factor for skip metastasis.…”

Section: Discussioncontrasting

confidence: 49%

Clinical Analysis of Risk Factors for Cervical Lymph Node Metastasis in Papillary Thyroid Microcarcinoma: A Retrospective Study of 3686 Patients

Song¹,

Yan²,

Qiu³

et al. 2020

CMAR

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To investigate the risk factors for cervical lymph node metastasis (LNM) in papillary thyroid microcarcinoma (PTMC). Patients and Methods: In total, 3686 patients with PTMC who underwent initial surgery in Shanghai Jiao Tong University affiliated Sixth People's Hospital from January 2010 to December 2019 were retrospectively analyzed. Univariate and multivariate analyses were conducted to identify risk factors associated with cervical LNM.

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Section: Discussioncontrasting

confidence: 49%

Clinical Analysis of Risk Factors for Cervical Lymph Node Metastasis in Papillary Thyroid Microcarcinoma: A Retrospective Study of 3686 Patients

Song¹,

Yan²,

Qiu³

et al. 2020

CMAR

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“…Whereas, without central metastases, the lateral LNM can also occur in PTC patients, known as skip metastasis. 27 This study found that skip metastasis was more common in patients with SLNM than in patients with MLNM, supported by previous reports. 26,31 ROC curve analysis determined that 1.15 cm was an optimal tumor size cutoff for predicting MLNM.…”

Section: Discussionsupporting

confidence: 90%

“…LNM is a risk factor for recurrence in PTC. 27,28 Lymph node dissection can significantly improve prognosis, so lymph nodes should be carefully evaluated before surgery. At present, there is still no clear suggestion on the scope of lateral neck dissection.…”

Section: Discussionmentioning

confidence: 99%

Preoperative Sonographic and Clinicopathological Predictors for Solitary Lateral Neck Node Metastasis in Papillary Thyroid Carcinoma: A Retrospective Study

Yang

Chen

et al. 2020

CMAR

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Background: Cervical lymph node metastasis (LNM) is an independent risk factor for poor prognosis of papillary thyroid carcinoma (PTC), but the scope of PTC lateral neck dissection (LND) is controversial. Solitary lateral lymph node metastasis (SLNM) is a special type of PTC with lateral LNM. Currently, study on the preoperative clinical characteristics of SLNM has been seldomly reported. This study evaluated the preoperative characteristics for predicting the SLNM of PTC. Methods: We included 391 patients diagnosed with PTC between May 2011 and July 2017. Among those patients, 44 had SLNM and 347 had multiple lateral neck node metastasis (MLNM). The clinicopathologic characteristics and other central lymph node metastasis risk factors were retrospectively analyzed. Results: Univariate analysis revealed that age and tumor size (≤1 cm) were significantly correlated with SLNM. In ROC curve analysis, the optimal cutoff age of preoperative predictors for the prediction of SLNM was 46.5 years (AUC=0.623, 0.536-0.710). Besides, the frequency and mean number of CLNM was significantly less in the SLNM than MLNM group. The oval and round tumor shape and well-defined margin of the tumor were more common in the SLNM group (p =0.001; p=0.024, respectively). In addition, multivariate analysis revealed that age ≥47, capsular invasion, no extrathyroidal extension, with central lymph node metastases and irregular shape were independent SLNM predictors of PTCs (odds ratio 2.386, 0.173, 0.284, 0.239, 0.188; 95%

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“…Subsequently, we noted that female sex, advanced age, inferior lobe of the thyroid, MTD < 1 cm, and nodular goiter were positively associated with the incidence of skip metastases, while capsular infiltration was negatively associated with skip metastases in multivariate analysis. Similar to these results, Jin et al and Nie et al also found that small TCs (MTD < 1 cm) are more likely to have skip metastases (24,25).…”

Section: Skip Metastasissupporting

confidence: 71%

Lymph node characteristics of 6279 N1 differentiated thyroid cancer patients

Sui

et al. 2020

Endocrine Connections

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Purpose This study examined the clinicopathological characteristics of 6279 N1 differentiated thyroid cancer (DTC) patients who underwent operations in our center. Methods This was a retrospective longitudinal analysis. We categorized the DTC patients on the basis of various lymph node (LN) characteristics. Logistic regression models and multiple linear regression models were used for the correlation analysis. Results A total of 3693 (58.8%) N1a patients and 2586 (41.2%) N1b patients were included. Patients with N1b disease had larger metastatic foci (0.5 vs 0.15 cm), a greater number of metastatic LNs (5 vs 2), a greater number of dissected LNs (25 vs 7), and a smaller lymph node ratio (NR, number of positive LNs/number of sampled LNs) (23.1% vs 28.6%) than patients in stage N1a. Comparing the clinicopathological features, we found that male, increased tumor size, multifocality, and thyroiditis increased the risk of stage N1b disease (P < 0.05). Sex, multifocality, capsular infiltration, and tumor size were associated with the size of the metastatic LNs (P < 0.05). Sex, capsular infiltration, and nodular goiter were associated with the NR (P < 0.05). Female sex, tumor located in inferior lobe, maximal tumor diameter (MTD) < 1 cm, and nodular goiter were independent predictors for skip metastases (P < 0.05). MTD > 1 cm, central neck metastasis and age were independent predictors for bilateral lateral neck metastasis (BLNM) (P < 0.05). Conclusion The LN characteristics of stage N1a and N1b disease were associated with significantly different features, such as sex, tumor size, multifocality, capsular infiltration, and nodular goiter.

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Skip metastasis in papillary thyroid carcinoma is difficult to predict in clinical practice

Cited by 42 publications

References 43 publications

<p>Clinical Analysis of Risk Factors for Cervical Lymph Node Metastasis in Papillary Thyroid Microcarcinoma: A Retrospective Study of 3686 Patients</p>

<p>Clinical Analysis of Risk Factors for Cervical Lymph Node Metastasis in Papillary Thyroid Microcarcinoma: A Retrospective Study of 3686 Patients</p>

<p>Preoperative Sonographic and Clinicopathological Predictors for Solitary Lateral Neck Node Metastasis in Papillary Thyroid Carcinoma: A Retrospective Study</p>

Lymph node characteristics of 6279 N1 differentiated thyroid cancer patients

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