Soo Youn Cho1, Tae Hyun Lee2, Yun Hyi Ku3, Hong Il Kim3, Guk Haeng Lee4, Min Joo Kim5. 1. Department of Pathology, Korea Cancer Center Hospital, Seoul, Republic of Korea; Department of Pathology, Samsung Medical Center, Seoul, Republic of Korea. 2. Department of Radiology, Korea Cancer Center Hospital, Seoul, Republic of Korea. 3. Department of Internal Medicine, Korea Cancer Center Hospital, Seoul, Republic of Korea. 4. Department of Otorhinolaryngology, Korea Cancer Center Hospital, Seoul, Republic of Korea. 5. Department of Internal Medicine, Korea Cancer Center Hospital, Seoul, Republic of Korea. Electronic address: chorong24@gmail.com.
Abstract
BACKGROUND: Lymph node (LN) metastasis is common in papillary thyroid microcarcinoma (PTMC). The aim of this study was to investigate the impact of LN metastasis and its risk stratification on PTMC recurrence. METHODS: We retrospectively reviewed the data of 336 patients with PTMC who underwent surgery from 2005 to 2006 at a single institution. LN metastasis was stratified according to the number of metastatic LNs, the ratio of metastatic to removed LNs, the size of metastatic foci in LNs, and the presence of extranodal extension and desmoplasia. RESULTS: Of the 336 patients, 93 (28%) had LN metastasis. During the follow-up of 5.3 years, 16 (4.8%) experienced locoregional recurrence. Among several clinicopathologic factors, LN metastasis was the most important risk factor for recurrence (P = .02). Lateral LN metastasis was correlated with recurrence-free survival (P < .01), whereas central LN metastasis was not (P = .20). When central LN metastasis was stratified, a high number of metastatic LNs (≥3), larger metastatic foci (≥0.2 cm), and the presence of desmoplasia were associated with recurrence-free survival (P < .05). CONCLUSION: The prognostic significance of central LN metastasis can differ according to the number of metastatic LNs, the size of metastatic foci, and the presence of desmoplasia. Patients with a high number of metastatic LNs, larger metastatic foci, and presence of desmoplasia in LNs should be treated aggressively and supervised carefully for PTMC recurrence.
BACKGROUND: Lymph node (LN) metastasis is common in papillary thyroid microcarcinoma (PTMC). The aim of this study was to investigate the impact of LN metastasis and its risk stratification on PTMC recurrence. METHODS: We retrospectively reviewed the data of 336 patients with PTMC who underwent surgery from 2005 to 2006 at a single institution. LN metastasis was stratified according to the number of metastatic LNs, the ratio of metastatic to removed LNs, the size of metastatic foci in LNs, and the presence of extranodal extension and desmoplasia. RESULTS: Of the 336 patients, 93 (28%) had LN metastasis. During the follow-up of 5.3 years, 16 (4.8%) experienced locoregional recurrence. Among several clinicopathologic factors, LN metastasis was the most important risk factor for recurrence (P = .02). Lateral LN metastasis was correlated with recurrence-free survival (P < .01), whereas central LN metastasis was not (P = .20). When central LN metastasis was stratified, a high number of metastatic LNs (≥3), larger metastatic foci (≥0.2 cm), and the presence of desmoplasia were associated with recurrence-free survival (P < .05). CONCLUSION: The prognostic significance of central LN metastasis can differ according to the number of metastatic LNs, the size of metastatic foci, and the presence of desmoplasia. Patients with a high number of metastatic LNs, larger metastatic foci, and presence of desmoplasia in LNs should be treated aggressively and supervised carefully for PTMC recurrence.
Authors: Yawen Guo; Zeming Liu; Pan Yu; Chunping Liu; Jie Ming; Ning Zhang; Maimaiti Yusufu; Chen Chen; Tao Huang Journal: Int J Clin Exp Med Date: 2015-06-15
Authors: Cristina Valero; Daniella K Zanoni; Anjali Pillai; Bin Xu; Nora Katabi; Ronald A Ghossein; Ian Ganly; Luc G T Morris; Jatin P Shah; Richard J Wong; Snehal G Patel Journal: J Surg Oncol Date: 2020-09-24 Impact factor: 3.454