Young Woo Chang1, Hwan Soo Kim1, Hoon Yub Kim1, Jae Bok Lee1, Jeoung Won Bae1, Gil Soo Son2. 1. Department of Breast Endocrine Surgery, Korea University Medical Center, Seoul, Republic of Korea; Department of Surgery, Korea University College of Medicine, Seoul, Republic of Korea. 2. Department of Breast Endocrine Surgery, Korea University Medical Center, Seoul, Republic of Korea; Department of Surgery, Korea University College of Medicine, Seoul, Republic of Korea. Electronic address: gsson@korea.ac.kr.
Abstract
BACKGROUND: Central lymph node dissection (CLND) in patients with papillary thyroid microcarcinoma (PTMC) is still controversial. The aim of this study was to examine the risk factors and the incidence of central lymph node metastases (CLNMs) in patients with PTMC who underwent thyroidectomy and CLND. PATIENTS AND METHODS: Between 2002 and 2013, 613 patients were enrolled who underwent thyroidectomy with routine CLND for PTMC at the Korea University Medical Center, Ansan Hospital and risk factors and the incidence of CLNM were analyzed. In addition, we also evaluated the complications after thyroidectomy with CLND. RESULTS: Out of 613 patients, 239 (39.0%) were found to have CLNM. Male sex (p = 0.012), tumor size ≥ 0.5 cm (p = 0.001), capsular invasion or extrathyroidal extension (p = 0.029), and multifocality (p = 0.004) were independent risk factors for CLNM. Among the 69 patients who had PTMC without these risk factors, CLNM was identified in 12 (17.4%). In this study group, two (0.3%) had permanent recurrent laryngeal nerve injury, two (0.3%) had persistent hypocalcemia, and two (0.3%) developed postoperative hemorrhage. CONCLUSION: CLNM in PTMC is highly prevalent in male sex, tumor size ≥ 0.5 cm, extrathyroidal extension, and multifocality. Even in PTMC patients without these risk factors, the incidence of CLNM is rather higher than expected, and the complication rate of thyroidectomy with CLND is acceptable. Thus, CLND should be considered in all patients with PTMC.
BACKGROUND: Central lymph node dissection (CLND) in patients with papillary thyroid microcarcinoma (PTMC) is still controversial. The aim of this study was to examine the risk factors and the incidence of central lymph node metastases (CLNMs) in patients with PTMC who underwent thyroidectomy and CLND. PATIENTS AND METHODS: Between 2002 and 2013, 613 patients were enrolled who underwent thyroidectomy with routine CLND for PTMC at the Korea University Medical Center, Ansan Hospital and risk factors and the incidence of CLNM were analyzed. In addition, we also evaluated the complications after thyroidectomy with CLND. RESULTS: Out of 613 patients, 239 (39.0%) were found to have CLNM. Male sex (p = 0.012), tumor size ≥ 0.5 cm (p = 0.001), capsular invasion or extrathyroidal extension (p = 0.029), and multifocality (p = 0.004) were independent risk factors for CLNM. Among the 69 patients who had PTMC without these risk factors, CLNM was identified in 12 (17.4%). In this study group, two (0.3%) had permanent recurrent laryngeal nerve injury, two (0.3%) had persistent hypocalcemia, and two (0.3%) developed postoperative hemorrhage. CONCLUSION: CLNM in PTMC is highly prevalent in male sex, tumor size ≥ 0.5 cm, extrathyroidal extension, and multifocality. Even in PTMC patients without these risk factors, the incidence of CLNM is rather higher than expected, and the complication rate of thyroidectomy with CLND is acceptable. Thus, CLND should be considered in all patients with PTMC.
Authors: Krzysztof Kaliszewski; Beata Wojtczak; Marta Strutyńska-Karpińska; Tadeusz Łukieńczuk; Zdzisław Forkasiewicz; Paweł Domosławski Journal: Oncol Lett Date: 2016-05-30 Impact factor: 2.967
Authors: Young Woo Chang; Hwan Soo Kim; Seung Pil Jung; Hoon Yub Kim; Jae Bok Lee; Jeoung Won Bae; Gil Soo Son Journal: Int J Clin Oncol Date: 2016-02-02 Impact factor: 3.402
Authors: Young Woo Chang; Hye Yoon Lee; Hwan Soo Kim; Hoon Yub Kim; Jae Bok Lee; Gil Soo Son Journal: Ann Surg Treat Res Date: 2018-04-30 Impact factor: 1.859
Authors: Young Woo Chang; Hwan Soo Kim; Seung Pil Jung; Hoon Yub Kim; Jae Bok Lee; Jeoung Won Bae; Gil Soo Son Journal: Ann Surg Treat Res Date: 2017-02-24 Impact factor: 1.859