Total tumor diameter is a better indicator of multifocal papillary thyroid microcarcinoma: A propensity score matching analysis

Jiang, Kecheng; Lin, Bei; Zhao, Lingqian; Luo, Dingcun

doi:10.3389/fendo.2022.974755

Cited by 3 publications

(2 citation statements)

References 25 publications

(28 reference statements)

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“…Additionally, TTD’s significance in thyroid cancer has been documented in prior researches. They found that TTD was associated with lymph node metastasis and may represent the tumor biological traits and aggressiveness more accurately than MTD ( 9 , 11 , 12 , 16 ). However, the researchers treated unilateral multifocality and bilaterality as the same multifocality types.…”

Section: Discussionmentioning

confidence: 99%

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The value of total tumor diameter in unilateral multifocal papillary thyroid carcinoma: a propensity score matching analysis

Wu,

Xia,

Chen

et al. 2023

Front. Endocrinol.

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BackgroundTumor multifocality is frequently observed in papillary thyroid carcinoma (PTC). However, the maximum tumor diameter (MTD), currently utilized in various staging schemes, might not accurately indicate the level of aggressiveness exhibited by multifocal tumors. We aimed to investigate the relationship between total tumor diameter (TTD) and clinicopathological features of papillary thyroid carcinoma.MethodsRetrospective data analysis was done on 1936 individuals who underwent complete thyroidectomy for PTC. Patients were classified into subgroups according to unilateral multifocality, central lymph node metastasis (CLNM) and lateral lymph node metastasis (LLNM). The relationships of clinicopathological features among these groups were analyzed.ResultsUnilateral multifocality was observed in 117 patients. The clinicopathological features of the unilateral multifocal PTC were similar to the unifocal PTC with approximate TTD. The unilateral multifocality played no independent role in CLNM and LLNM. Moreover, the efficiency of TTD in predicting CLNM and LLNM was significantly higher than that of MTD.ConclusionIn the case of unilateral multifocal PTC, TTD is a more accurate indicator of the biological characteristics of the tumor than MTD.

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Section: Discussionmentioning

confidence: 99%

“…In recent years, many studies have also reported the concept of total tumor diameter (TTD) (9)(10)(11). Some demonstrated that TTD could reflect a tumor's biological characteristics and aggressiveness more accurately than MTD (12).…”

Section: Introductionmentioning

confidence: 99%

The value of total tumor diameter in unilateral multifocal papillary thyroid carcinoma: a propensity score matching analysis

Wu,

Xia,

Chen

et al. 2023

Front. Endocrinol.

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Nomogram prediction for cervical lymph node metastasis in multifocal papillary thyroid microcarcinoma

et al. 2023

Front. Endocrinol.

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AimAccurate preoperative prediction of cervical lymph node metastasis (LNM) in patients with mPTMC provides a basis for surgical decision making and the extent of tumor resection. This study aimed to develop and validate an ultrasound radiomics nomogram for the preoperative assessment of LN status.MethodsA total of 450 patients pathologically diagnosed with mPTMC were enrolled, including 348 patients in the modeling group and 102 patients in the validation group. Univariate and multivariate logistic regression analyses were performed on the basic information, ultrasound characteristics, and American College of Radiology Thyroid Imaging Reporting and Data System (ACR TI-RADS) scores of the patients in the modeling group to identify independent risk factors for LNM in mPTMC and to construct a logistic regression equation and nomogram to predict the risk of LNM. The validation group data were used to evaluate the predictive performance of the nomogram.ResultsMale sex, age <40 years, a single lesion with a maximum diameter >0.5 cm, capsular invasion, a maximum ACR score >9 points, and a total ACR score >19 points were independent risk factors for the development of cervical LNM in mPTMC. Both the area under the curve (AUC) and concordance index (C-index) of the prediction model constructed from the above six factors were 0.838. The calibration curve of the nomogram was close to the ideal diagonal line. Furthermore, decision curve analysis (DCA) demonstrated a significantly greater net benefit of the model. The external validation demonstrated the reliability of the prediction nomogram.ConclusionsThe presented radiomics nomogram, which is based on ACR TI-RADS scores, shows favorable predictive value for the preoperative assessment of LNs in patients with mPTMC. These findings may provide a basis for surgical decision making and the extent of tumor resection.

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The Impact of Total Tumor Diameter on Lymph Node Metastasis and Tumor Recurrence in Papillary Thyroid Carcinomas

Can,

Bulbul,

Ozyilmaz

et al. 2024

Diagnostics

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(1) Introduction: The impact of multifocality/bilaterality on the prognosis of papillary thyroid carcinoma (PTC) is a matter of debate. In order to clarify this debate, several studies have attempted to identify additional parameters associated with poor prognosis, including total tumor diameter (TTD), in the context of multifocal PTCs. In this context, this study was carried out to investigate the impact of TTD on tumor recurrence and lymph node metastasis (LNM) in PTCs. (2) Materials and Methods: The sample of this single-center retrospective study consisted of 706 patients diagnosed with PTC. TTD was calculated as the sum of the largest diameters of tumor foci in multifocal tumors. The resulting TTDs were grouped into TTDs ≤ 10 mm, TTDs > 10 mm, TTDs ≤ 20 mm, and TTDs > 20 mm, using 10 mm and 20 mm as cutoff values. (3) Results: There was no significant difference between multifocal papillary microcarcinomas (PTMCs) with a TTD of >10 mm and unifocal PTCs with a primary tumor diameter (PTD) of >10 mm except for advanced age and lymphovascular invasion (LVI). In addition, perineural invasion (PNI) and TTD > 10 mm were found to be significant risk factors for LNM, and PNI, TTD > 10 mm, TTD > 20 mm, and bilaterality were found to be significant risk factors for recurrence. LVI, and TTD > 10 mm were found to be independent significant predictors for recurrence, and LVI and extrathyroidal extension (ETE) were found to be independent significant predictors for LNM. (4) Conclusions: Considering TTD > 10 mm in recurrence risk categorization models and adopting a clinical approach that takes into account multifocal PTMCs with TTD > 10 mm along with unifocal PTCs with PTD > 10 mm may be more useful in terms of clinical management of the disease.

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Total tumor diameter is a better indicator of multifocal papillary thyroid microcarcinoma: A propensity score matching analysis

Cited by 3 publications

References 25 publications

The value of total tumor diameter in unilateral multifocal papillary thyroid carcinoma: a propensity score matching analysis

The value of total tumor diameter in unilateral multifocal papillary thyroid carcinoma: a propensity score matching analysis

Nomogram prediction for cervical lymph node metastasis in multifocal papillary thyroid microcarcinoma

The Impact of Total Tumor Diameter on Lymph Node Metastasis and Tumor Recurrence in Papillary Thyroid Carcinomas

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