The characteristics and risk factors of central compartment lymph node metastasis in cN0 papillary thyroid carcinoma coexistent with Hashimoto’s thyroiditis

Jin, Kai; Li, Liang; Liu, Yahang; Wang, Xudong

doi:10.21037/gs-20-699

Cited by 6 publications

(6 citation statements)

References 24 publications

(29 reference statements)

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“…Our study also indicated that the TSH in HT patients was higher than that in patients with PTC alone. These results were consistent with many other previous observations ( 24 , 30 ). HT, which is characterized by the infiltration of abundant lymphocytes, fibrosis, and parenchymal atrophy of thyroid tissue, is an autoimmune inflammation of the thyroid.…”

Section: Discussionsupporting

confidence: 94%

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The Impact of Coexistent Hashimoto’s Thyroiditis on Central Compartment Lymph Node Metastasis in Papillary Thyroid Carcinoma

Liu

Zhang

et al. 2021

Front. Endocrinol.

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BackgroundHashimoto’s thyroiditis (HT) is the most prevalent inflammatory disorder of the thyroid gland. Current studies have reported the coexistence rate between HT and papillary thyroid carcinoma (PTC) is quite high. The objective of this study was to evaluate the impact of HT on the predictive factors of central compartment lymph node metastasis (CLNM) in PTC.MethodsA retrospective investigation was performed on PTC patients. They were subclassified into HT and non-HT groups. The results of preoperative neck ultrasound (US) examinations were reviewed. The clinical characteristics and the predictive value for CLNM were explored and compared between the two groups.ResultsA total of 756 patients were included in this study. There were more female patients (86.1%) in the PTC coexistent with the HT group than non-HT group. The patients with HT group had higher preoperative serum level of TSH. There was statistically significant difference between the HT patients and non-HT patients in nodular vascularization. Univariate and multivariate analyses showed that male, age ≤45 years old, tumor diameter >1 cm, and presence of suspicious central compartment lymph node on US, irregular nodular shape, multifocal carcinoma were independent predictive factors of CLNM in PTC patients. It was showed that male, age ≤45 years old, tumor diameter >1 cm, multifocality, and presence of suspicious central lymph node on US were risk factors for CLNM in non-HT patients. Only tumor diameter >1 cm and presence of suspicious central lymph node on US were independently correlated with CLNM in HT patients. The sensitivity of the multivariate model was 63.5%, and specificity was 88.9% for prediction CLNM in HT patients. For non-HT patients, the AUC was 80.6%, the sensitivity of the multivariate model was 64.5%, and specificity was 85.2%ConclusionPTC combined with HT is more common in women, and TSH level in HT group is higher than that in patients with PTC alone. Regardless of that HT is not a related risk factor of CLNM in PTC, our result suggested that different predictive systems should be used for HT and non-HT patients respectively to have a more accurate evaluation of CLNM in clinic.

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Section: Discussionsupporting

confidence: 94%

“…However, an overly aggressive dissection that may damage the normal function of the RLN is not necessary ( 37 ). Therefore, the accurate identification of risk factors of CLNM is helpful to evaluate the status of CLN and determine the necessity of lymph node dissection, especially for PTC patients with HT ( 30 ).…”

Section: Discussionmentioning

confidence: 99%

The Impact of Coexistent Hashimoto’s Thyroiditis on Central Compartment Lymph Node Metastasis in Papillary Thyroid Carcinoma

Liu

Zhang

et al. 2021

Front. Endocrinol.

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“…Our study also indicated that the TSH in HT patients was higher than that in patients with PTC alone. These results were consistent with many other previous observations (24,30). HT, which is characterized by the infiltration of abundant lymphocytes, fibrosis, and parenchymal atrophy of thyroid tissue, is an autoimmune inflammation of the thyroid.…”

Section: Discussionsupporting

confidence: 94%

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“…A meta-analysis of 71 studies, which included 44034 patients, showed that thyroid cancer with or without lymph node involvement is much less common in patients with Hashimoto’s thyroiditis. Hashimoto’s thyroiditis also reduces the risk of cancer recurrence in patients operated on for malignant tumors of the thyroid gland ( 27 , 28 ).…”

Section: Central Lymph Node Dissection and Its Advantagesmentioning

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 characteristics and risk factors of central compartment lymph node metastasis in cN0 papillary thyroid carcinoma coexistent with Hashimoto’s thyroiditis

Cited by 6 publications

References 24 publications

The Impact of Coexistent Hashimoto’s Thyroiditis on Central Compartment Lymph Node Metastasis in Papillary Thyroid Carcinoma

The Impact of Coexistent Hashimoto’s Thyroiditis on Central Compartment Lymph Node Metastasis in Papillary Thyroid Carcinoma

Table_1.doc

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

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