Surgical Extent of Central Lymph Node Dissection for Papillary Thyroid Carcinoma Located in the Isthmus: A Propensity Scoring Matched Study

Shuai, Yanjie; Yue, Kai; Duan, Yuansheng; Zhou, Mengqian; Fang, Yan; Liu, Jin; Liu, Dandan; Jing, Chao; Wu, Yi‐Long; Wang, Xudong

doi:10.3389/fendo.2021.620147

Cited by 8 publications

(7 citation statements)

References 36 publications

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“…Skilled specialists can even reduce the incidence of thyroid surgery complications to below 1%. 12 , 13 …”

Section: Discussionmentioning

confidence: 99%

“…Skilled specialists can even reduce the incidence of thyroid surgery complications to below 1%. 12,13 The principle of TSH suppression therapy is drawing on hormone increasing plasma T3 and T4 concentrations to normal upper limit, inhibit the synthesis and release of TSH, so as to inhibit tumor growth and metastasis. 14,15 It has been reported that continuous high levels of thyroid hormone may significantly increase the occurrence of cardiovascular and other adverse events in patients aged >60.…”

Section: A H E a D O F P R I N Tmentioning

confidence: 99%

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Expression and Clinical Significance of Thyroid-stimulating hormone receptor in the Subtypes of Papillary thyroid carcinomas

Shen

Zhang²,

Li³

2022

Pak J Med Sci

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Objective: To investigate the expression of TSH receptors (TSHR) in various subtypes of Papillary thyroid carcinomas (PTC) by immunohistochemistry. Methods: Retrospective analyses were carried out to the clinical data of 108 PTC patients randomly admitted into the Department of Thyroid and Breast Surgery, The Second Hospital of Hebei Medical University from March 2020 to December 2020. The archived paraffin blocks of the 108 cases as well as 18 contiguous normal thyroid tissues (control group) were taken from the Department of Pathology of The Second Hospital of Hebei Medical University. The pathological types of all PTC tissues were detected and the expression of TSHR was determined. Results: TSHR expression was 86.11% positive in PTC tissues; with 85.00% positive in classical group; with 75.86% positive in micro group; with 84.61% positive in follicular group; with 83.33% positive in oncocytic group; with 50.00% positive in invasive group. TSHR expression was 100% in normal thyroid tissues. So TSHR expression in normal thyroid tissues is significantly higher than that in PTC; TSHR expression in microcarcinoma is stronger than in the other subtypes; there is no significant difference among the other subtypes. Conclusions: TSH suppression works better on microcarcinoma than on the other subtypes. And the effects on non-invasive subtypes are better than on invasive subtypes. doi: https://doi.org/10.12669/pjms.39.1.6096 How to cite this: Shen W, Zhang S, Li Q. Expression and Clinical Significance of Thyroid-stimulating hormone receptor in the Subtypes of Papillary thyroid carcinomas. Pak J Med Sci. 2023;39(1):---------. doi: https://doi.org/10.12669/pjms.39.1.6096 This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/3.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

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“…Skilled specialists can even reduce the incidence of thyroid surgery complications to below 1%. 12 , 13 …”

Section: Discussionmentioning

confidence: 99%

Section: A H E a D O F P R I N Tmentioning

confidence: 99%

Expression and Clinical Significance of Thyroid-stimulating hormone receptor in the Subtypes of Papillary thyroid carcinomas

Shen

Zhang²,

Li³

2022

Pak J Med Sci

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“…The risk group for detecting metastases in lymph nodes in the absence of information about their presence before surgery includes the following factors: male sex, age less than 45 years, multiple tumors, tumor size more than 2 cm, localization in the center of the lobe or at the lower pole, invasion into vessels, spread outside the thyroid gland capsule ( 74 ). Other factors may include isthmus location of the tumor, male sex, age less thatn 45 years, tumor adjacent to dorsal membranes, and irregular borders ( 75 , 76 ). Most meta-analyses up to 2013 indicated a lack of data that central lymph node dissection somehow reduces the risk of locoregional cancer recurrence ( Table 4 ).…”

Section: Recommendations Of Professional Communities and The Risk Of ...mentioning

confidence: 99%

A Narrative Review of Preventive Central Lymph Node Dissection in Patients With Papillary Thyroid Cancer - A Necessity or an Excess

et al. 2022

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ObjectiveThis review article summarises the latest evidence for preventive central lymph node dissection in patients with papillary thyroid cancer taking into account the possible complications and risk of recurrence.BackgroundPapillary thyroid cancer is the most frequent histological variant of malignant neoplasms of the thyroid gland. It accounts for about 80-85% of all cases of thyroid cancer. Despite good postoperative results and an excellent survival rate in comparison with many other malignant diseases, tumor metastases to the cervical lymph nodes are frequent. Most researchers agree that the presence of obvious metastases in the lymph nodes requires careful lymph node dissection. It was suggested to perform preventive routine lymphadenectomy in all patients with malignant thyroid diseases referred to surgery.MethodsIt was performed the literature review using the “papillary thyroid cancer”, “central lymph node dissection”, “hypocalcemia”, “recurrent laryngeal nerve paresis”, “metastasis”, “cancer recurrence” along with the MESH terms. The reference list of the articles was carefully reviewed as a potential source of information. The search was based on Medline, Scopus, Google Scholar, eLibrary engines. Selected publications were analyzed and their synthesis was used to write the review and analyse the role of preventive central lymph node dissection in patients with papillary thyroid cancer.ConclusionsThe necessity of preventive central lymph node dissection in patients with differentiated papillary thyroid carcinoma is still controversial. There is much evidence that it increases the frequency of transient hypocalcemia. Due to the fact that this complication is temporary, its significance in clinical practice is debatable. It can also be assumed that an extant of surgery in the neck area is associated with an increased risk of recurrent laryngeal nerve injury. However, most studies indicate that this injury is associated more with thyroidectomy itself than with lymph node dissection. Recurrent laryngeal nerve dysfunction is also a temporary complication in the vast majority of cases. At the same time, a large amount of data shows that central lymph node dissection reduces the risk of thyroid cancer recurrence in two times.

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“…The isthmus is a thin thyroid parenchyma that connects both thyroid lobes anteriorly to the trachea. Isthmic PTC is more frequently associated with local invasion of adjacent tissues, bilateral lymph node involvement, and multifocality than PTC located in other parts of the thyroid gland ( 1 - 8 ). Therefore, many surgeons prefer total thyroidectomy and central compartment neck dissection (CCND) for primary treatment of PTC located in the isthmus ( 1 , 3 , 8 - 14 ).…”

Section: Introductionmentioning

confidence: 99%

Implications of isthmic location as a risk factor in papillary thyroid carcinoma

Kwon¹,

Lee²,

Bae³

et al. 2023

Gland Surg

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Background Papillary thyroid carcinoma (PTC) located in the isthmus generally has been known to have more extrathyroidal extension (ETE), lymph node involvement, and multifocality. The purpose of this study was to determine the clinical significance of an isthmic location of PTC. Methods The records of 160 patients who underwent a total thyroidectomy due to a single, dominant isthmic PTC were retrospectively reviewed. The characteristics of isthmic cancer were compared with those of unilateral-lobar cancer in a PTC cohort at Seoul St. Mary’s hospital. After propensity score matching for age, sex, and tumor size, 160 isthmic PTCs and 800 unilateral-lobar PTCs were compared. The clinicopathologic characteristics were analyzed to evaluate the prognostic significance of an isthmic tumor location. Results The isthmic group was significantly older (49.6 vs . 46.8 years, P=0.007) and had a smaller mean tumor size (0.8±0.4 vs . 1.0±0.7 cm, P<0.001) than the unilateral-lobar group. After propensity score matching, tumor size categories, ETE, multifocality, nodal metastasis and proportion of patients with more than five metastatic lymph nodes were similar in both groups. However, N1b cases were more frequent in the unilateral-lobar group both before and after propensity score matching. In multivariate analysis, isthmic location was not correlated with gross ETE, multifocality, and higher-risk N1 disease. Younger age and more than five metastatic nodes increased the risk of PTC recurrence. However, isthmic tumor location was not significantly correlated with recurrence-free survival. Conclusions Isthmic location is not an independent risk factor for aggressive clinicopathologic features and is not related to PTC recurrence.

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Surgical Extent of Central Lymph Node Dissection for Papillary Thyroid Carcinoma Located in the Isthmus: A Propensity Scoring Matched Study

Cited by 8 publications

References 36 publications

Expression and Clinical Significance of Thyroid-stimulating hormone receptor in the Subtypes of Papillary thyroid carcinomas

Expression and Clinical Significance of Thyroid-stimulating hormone receptor in the Subtypes of Papillary thyroid carcinomas

A Narrative Review of Preventive Central Lymph Node Dissection in Patients With Papillary Thyroid Cancer - A Necessity or an Excess

Implications of isthmic location as a risk factor in papillary thyroid carcinoma

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