Young Age and Male Sex Are Predictors of Large-Volume Central Neck Lymph Node Metastasis in Clinical N0 Papillary Thyroid Microcarcinomas

Abstract

Large-volume LNM was more frequently found in young (<40 years) and male patients. These findings support the notion that surgery rather than observation may be favored in young and male clinically LN negative PTMC patients as a primary therapeutic option.

Recent Trends in the Clinicopathological Features of Thyroid Nodules in Pediatric Patients: A Single Tertiary Center Experience over 25 Years

“…e clinical behavior of thyroid cancer in children is known to be more aggressive than that in adults [7,9,10]. In our previous reports, we also found that a young age was related to the aggressive pattern of thyroid cancer [25][26][27]. e early detection of thyroid cancer in pediatric patients might therefore also contribute to improved clinical outcomes, as seen in adult patients [12,13].…”

The new 4th edition World Health Organization classification for thyroid tumors, Asian perspectives

“…Less than 15% of low‐risk PMC grow to more than 3 mm or develop lymph node metastasis during follow‐up, and most importantly, no thyroid cancer death was reported among more than 1000 patients for more than 10 years of follow‐up . Expert thyroid pathologists proposed calling it papillary microtumor instead of carcinoma, and a proposal to classify PMC in the borderline tumor category was reported by Kakudo et al However, papillary microtumor has not become a popular diagnosis among pathologists and clinicians because a significant amount of PMC cases (15–35%) have lymph node metastasis at surgery and rare cases (<0.4%) develop distant metastasis …”

“…[4][5][6][7][8]68,[74][75][76] Expert thyroid pathologists proposed calling it papillary microtumor instead of carcinoma, 77 and a proposal to classify PMC in the borderline tumor category was reported by Kakudo et al 48 However, papillary microtumor has not become a popular diagnosis among pathologists and clinicians because a significant amount of PMC cases (15-35%) have lymph node metastasis at surgery and rare cases (<0.4%) develop distant metastasis. [65][66][67][68][71][72][73][74][75][76][77][78][79][80]…”

The Number of Central Lymph Nodes on Preoperative Ultrasound Predicts Central Neck Lymph Node Metastasis in Papillary Thyroid Carcinoma: A Prospective Cohort Study

“…Age at diagnosis of thyroid cancer is identified as an independent predictor of disease-specific survival in most published staging systems [20,21]. A previous study showed that large-volume CLNM was more frequently observed in younger patients [19]. is phenomenon was also demonstrated by a recent international multicentre retrospective study in which the age cut-off was shifted from 45 to 55 years [22].…”

“…Preoperative neck US has a low sensitivity (44.4%) for detecting CLN metastasis (CLNM) [14]. A recent trend toward routine central LN dissection avoiding radioactive treatment is still debated [15][16][17], and prophylactic central neck dissection (pCND) in patients with clinically uninvolved cN0 has been ineffective in some studies and is accompanied by postoperative complications [18,19]. us, finding preoperative features to predict CLNM is crucial, particularly large-volume CLNM, for PTC patients.…”