The long term outcome of papillary thyroid carcinoma patients without primary central lymph node dissection: Expected improvement of routine dissection

Giles, Yasemin; Tunca, Fatih; Boztepe, Harika; Alagöl, Faruk; Terzioğlu, Tarık; Tezelman, Serdar

doi:10.1016/j.surg.2009.09.014

Cited by 27 publications

(13 citation statements)

References 22 publications

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“…The lymph node metastasis in papillary thyroid cancer has been found to have significant impact on disease-free and overall survival of patients [22, 23]. Giles et al [24] in their retrospective series of 343 patients with thyroidectomy but without CCD found a locoregional recurrence rate of 6% with a median followup of 9 ± 4 years, where central compartment lymph nodes were involved in 6 recurrent cases. Similarly, Moo et al [5], in their series, during a mean followup of 3.1 years, reported increased locoregional recurrences in the group undergoing total thyroidectomy alone (16.7%) compared to those with prophylactic central lymph nodes dissection (4.4%).…”

Section: Discussionmentioning

confidence: 99%

Pattern and Risk Factors of Central Compartment Lymph Node Metastasis in Papillary Thyroid Cancer: A Prospective Study from an Endocrine Surgery Centre

Agarwal

Chand

Jaiswal³

et al. 2012

Journal of Thyroid Research

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Lymphatic metastasis in papillary thyroid cancer (PTC) is eminent; however, the extent of central compartment lymph nodes dissection (CCD) is controversial and requires the knowledge of pattern and risk factors for central compartment lymph nodes metastasis (CCM). We did a prospective study of 47 cases with PTC who underwent total thyroidectomy (TT) with CCD with/without lateral lymph nodes dissection (LND). Clinicopathological profile including CCM as ipsilateral and contralateral was documented. On histopathology, the mean tumour size was 3.57 ± 2.42 cm 59.6% had CCM, which was bilateral in the majority (60.72%). The tumour-size was the most important predictor for lymph nodes metastasis-(P=0.018) whereas multicentricity-(P=0.002) and ipsilateral CCM-(P=0.001) were the predictors for contralateral CCM. The long-term morbidity of CCD done in primary setting is comparable with TT-alone. Bilateral CCD should be done with thyroidectomy in PTC, otherwise the risk of residual diseases and subsequent recurrence is high. The long-term morbidity is comparable in experienced hands.

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Section: Discussionmentioning

confidence: 99%

Pattern and Risk Factors of Central Compartment Lymph Node Metastasis in Papillary Thyroid Cancer: A Prospective Study from an Endocrine Surgery Centre

Agarwal

Chand

Jaiswal³

et al. 2012

Journal of Thyroid Research

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“…As we know PTC is a slow‐growing tumour, recurrences can occur as late as decades from initial diagnosis. Long‐term studies have reported recurrences up to 30% 43–45 . However, without a long‐term prospective randomized controlled trial, an accurate figure for recurrence is difficult to identify.…”

Section: Discussionmentioning

confidence: 99%

Central cervical lymph node metastases in papillary thyroid cancer: a systematic review of imaging‐guided and prophylactic removal of the central compartment

Mulla

Schulte

2011

Clinical Endocrinology

103

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“…The main argument for treatment such as prophylactic central lymph node metastasis or radioiodine ablation in PTC and PTMC patients is based on maximum clearance of the tumour, which could result in a decreased rate of recurrence, improved survival, and avoidance of reoperations in the central neck compartment 18–21 . Multifocality has been reported to be a negative prognostic factor for recurrence and is considered an important risk factor in many publications 22–26 .…”

Section: Discussionmentioning

confidence: 99%

Total tumour diameter is superior to unifocal diameter as a predictor of papillary thyroid microcarcinoma prognosis

Liu

Wang

Zeng

et al. 2017

Sci Rep

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The current American Joint Committee (AJCC) on Cancer TNM classification does not describe the treatment of multifocal papillary thyroid microcarcinomas (PTMCs) with a total tumour diameter (TTD) >1 cm. Herein, we investigated this PTMC subgroup in terms of extrathyroidal extension (ETE), local infiltration, central lymph node metastasis (LNM), and prognosis. Consecutive patients (n = 1102) were identified and the proportions of LNM, ETE, and local infiltration were similar between PTCs with a unifocal tumour diameter >1 cm and ≤2 cm and PTMCs with a multifocal TTD >1 cm and ≤2 cm. The proportions of LNM, ETE, and local infiltration were also similar between PTMCs with a unifocal diameter ≤1 cm vs. multifocal TTD ≤1 cm. However, when comparing PTMCs with a unifocal diameter ≤1 cm vs. multifocal TTD >1 cm, significant differences were observed. In the Kaplan-Meier analysis, significant differences were observed between PTMCs with a unifocal diameter ≤1 cm vs. multifocal TTD >1 cm and multifocal TTD ≤1 cm vs. multifocal TTD >1 cm. Accordingly, TTD may represent a more accurate criterion for tumour size of PTCs and should be considered in the revised AJCC staging system.According to the World Health Organization classification system, papillary thyroid microcarcinoma (PTMC) is defined as thyroid cancer measuring less than or equal to 1.0 cm in its greatest dimension th edition of the American Joint committee on Cancer (AJCC) tumour, node, metastasis (TNM) classification system for differentiated thyroid cancer defines T1a tumours as those with a tumour diameter ≤1 cm (PTMC) without extrathyroidal extension (ETE), and this subgroup of patients are recommended to undergo lobectomy. However, the AJCC classification system, along with the guidelines recommended by the American Thyroid Association, defines the tumour size according to the traditional intraglandular maximal tumour diameter, and whether the subgroup of patients with multifocal PTMC and a total tumour diameter (TTD) >1 cm shares the same features and prognosis as those with traditional PTMCs remain unclear.Hence, in the present study, we aimed to demonstrate whether the TTD should be used as a more accurate criterion for tumour size of papillary thyroid carcinomas (PTCs) and should be added as an additional prognostic factor in the AJCC classification system. ResultsOverall, the postoperative follow-up period ranged between 18-148 months, with a median follow-up of 61.0 months. Clinicopathological characteristics of the papillary thyroid microcarcinoma patients (n = 1102) and papillary thyroid carcinoma (1 < unifocal with diameter ≤ 2 cm) (n = 210) were present in Table 1. Among the 390 multifocal PTMC cases, 32.6% (n = 127) and 67.4% (n = 263) were unilateral and bilateral, respectively. A total

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The long term outcome of papillary thyroid carcinoma patients without primary central lymph node dissection: Expected improvement of routine dissection

Cited by 27 publications

References 22 publications

Pattern and Risk Factors of Central Compartment Lymph Node Metastasis in Papillary Thyroid Cancer: A Prospective Study from an Endocrine Surgery Centre

Pattern and Risk Factors of Central Compartment Lymph Node Metastasis in Papillary Thyroid Cancer: A Prospective Study from an Endocrine Surgery Centre

Central cervical lymph node metastases in papillary thyroid cancer: a systematic review of imaging‐guided and prophylactic removal of the central compartment

Total tumour diameter is superior to unifocal diameter as a predictor of papillary thyroid microcarcinoma prognosis

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