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Effects of Patient and Tumor Characteristics on Central Lymph Node Metastasis in Papillary Thyroid Cancer: A Guide for Selective Node Dissection.
- Source :
-
Archives of Iranian Medicine (AIM) . Nov2022, Vol. 25 Issue 11, p730-736. 7p. - Publication Year :
- 2022
-
Abstract
- Background: Prophylactic central lymph node dissection (CLND) in papillary thyroid carcinoma (PTC) is still controversial. This study aimed to analyze the factors related to the patient and tumor characteristics affecting central lymph node metastasis (CLNM) in PTC patients and to evaluate the contribution of the results to shaping the surgical treatment algorithm. Methods: Two hundred and fifty-five PTC patients who underwent total thyroidectomy and CLND were evaluated retrospectively. Histopathology reports were examined to reveal tumor characteristics. The CLNM ratio and the relationship between CLNM with clinicopathological and demographic characteristics were analyzed. Results: The incidence of CLNM was 54.9% (95 CI%: 49-60.8). Male gender (P = 0.027), age < 45 years (P = 0.016), tumor size ≥ 9.5 mm (P < 0.001), lymphovascular invasion (P < 0001) and extracapsular invasion (P = 0.007) were factors that increased the risk of metastasis. The follicular variant decreased the risk (P = 0.010). There was no relationship between CLNM and focality (P = 0.054). A low-to-moderate correlation was found between tumor diameter and the metastatic lymph node (MLN) number/total lymph node number ratio (r = 0.396, P < 0.001). Conclusion: A selective prophylactic CLND strategy can be applied in cN0 patients. As the tumor diameter increases in PTC, both the risk of CLNM and the number of MLN increase. Lymphovascular and extracapsular invasion are other factors that increase the risk. The follicular variant is associated with a lower risk of CLNM. Male patients who are under the age of 45 and have a tumor diameter of 9.5 mm or more are definite candidates for prophylactic CLND. [ABSTRACT FROM AUTHOR]
- Subjects :
- *CANCER patient psychology
*LYMPHADENECTOMY
*THYROIDECTOMY
*CONFIDENCE intervals
*PAPILLARY carcinoma
*THYROID gland tumors
*AGE distribution
*CANCER invasiveness
*PATIENT selection
*LYMPH nodes
*METASTASIS
*RETROSPECTIVE studies
*DISEASE incidence
*MEDICAL protocols
*RISK assessment
*SEX distribution
*TREATMENT effectiveness
*SYMPTOMS
*DESCRIPTIVE statistics
*HISTOLOGY
*ALGORITHMS
RISK of metastasis
Subjects
Details
- Language :
- English
- ISSN :
- 10292977
- Volume :
- 25
- Issue :
- 11
- Database :
- Academic Search Index
- Journal :
- Archives of Iranian Medicine (AIM)
- Publication Type :
- Academic Journal
- Accession number :
- 163156624
- Full Text :
- https://doi.org/10.34172/aim.2022.115