Hyoung Shin Lee1, Chanwoo Park1, Sung Won Kim1, Taejung Park2, Bong Kwon Chun3, Jong Chul Hong4, Kang Dae Lee1. 1. Department of Otolaryngology-Head and Neck Surgery, Kosin University College of Medicine, Busan, Korea. 2. Department of Otolaryngology-Head and Neck Surgery, Maryknoll Medical Center, Busan, Korea. 3. Department of Pathology, Kosin University College of Medicine, Busan, Korea. 4. Department of Otolaryngology-Head and Neck Surgery, Dong-A University College of Medicine, Busan, Korea.
Abstract
BACKGROUND: The impact of minimal extrathyroidal extension (mETE) to the prognosis of patients with papillary thyroid carcinoma (PTC) is controversial. In this study, we investigated whether mETE is related to the aggressive biology of metastatic lymph node (LN) in patients with PTC. METHODS: A retrospective review of 369 patients who had biopsy-confirmed cervical LN metastasis after initial surgery for PTC was conducted. The correlations of mETE with the specific features of metastatic LNs such as the LN size, number, LN ratio, and presence of extranodal extension (ENE) were statistically analyzed. RESULTS: Size of the primary tumor (≥1 cm) had independent correlations to mETE (HR = 5.750). While mETE was related to number of metastatic LNs (≥5), LN ratio (≥0.31) and ENE in univariate analysis, only ENE (HR = 2.322) was independently correlated to mETE in our series. Along with mETE, size of primary tumor (≥1 cm) had significant impact on ENE (HR = 2.107). CONCLUSION: Minimal ETE particularly those with larger primary tumor (≥1 cm) may be still considered as a significant factor regarding the management of cervical LNs in patients with PTC.
BACKGROUND: The impact of minimal extrathyroidal extension (mETE) to the prognosis of patients with papillary thyroid carcinoma (PTC) is controversial. In this study, we investigated whether mETE is related to the aggressive biology of metastatic lymph node (LN) in patients with PTC. METHODS: A retrospective review of 369 patients who had biopsy-confirmed cervical LN metastasis after initial surgery for PTC was conducted. The correlations of mETE with the specific features of metastatic LNs such as the LN size, number, LN ratio, and presence of extranodal extension (ENE) were statistically analyzed. RESULTS: Size of the primary tumor (≥1 cm) had independent correlations to mETE (HR = 5.750). While mETE was related to number of metastatic LNs (≥5), LN ratio (≥0.31) and ENE in univariate analysis, only ENE (HR = 2.322) was independently correlated to mETE in our series. Along with mETE, size of primary tumor (≥1 cm) had significant impact on ENE (HR = 2.107). CONCLUSION: Minimal ETE particularly those with larger primary tumor (≥1 cm) may be still considered as a significant factor regarding the management of cervical LNs in patients with PTC.