Jianbiao Wang1, Haili Sun2, Li Gao1, Lei Xie1, Xiujun Cai3. 1. Department of Head and Neck Surgery, Institute of Micro-Invasive Surgery of Zhejiang University, Sir Run Run Shaw Hospital, Zhejiang University School of Medicine, Hangzhou, Zhejiang, China. 2. Sir Run Run Shaw Hospital, Zhejiang University School of Medicine, Hangzhou, Zhejiang, China. 3. Department of General Surgery, Institute of Micro-Invasive Surgery of Zhejiang University, Sir Run Run Shaw Hospital, Zhejiang University School of Medicine, Hangzhou, Zhejiang, China.
Abstract
BACKGROUND: There are no specific therapeutic guidelines for thyroid cancers confined to the isthmus. To determine whether isthmic papillary thyroid carcinoma (PTC) can be treated with thyroid isthmusectomy and limited neck dissection, we analyzed factors related to central lymph node (CLN) metastasis in patients with clinically node-negative (cN0), solitary, isthmic PTC. METHODS: We retrospectively reviewed 73 consecutive patients who underwent surgery for solitary isthmic, PTC. The frequency, pattern, and risk factors of CLN metastasis were analyzed. RESULTS: Occult CLN metastasis and paratracheal lymph node (PTLN) metastasis were detected in 34 patients (46.6%) and 28 patients (38.4%), respectively. On multivariate logistic regression analysis, male sex and tumor size >0.7 cm were associated with CLN metastasis, and age ≤38 years, tumor size >0.6 cm, and pretracheal lymph node positivity were associated with PTLN metastasis. CONCLUSION: Thyroid isthmusectomy for solitary isthmic PTC may be insufficient in patients with tumors >0.6 cm, those aged ≤38 years, and male patients.
BACKGROUND: There are no specific therapeutic guidelines for thyroid cancers confined to the isthmus. To determine whether isthmic papillary thyroid carcinoma (PTC) can be treated with thyroid isthmusectomy and limited neck dissection, we analyzed factors related to central lymph node (CLN) metastasis in patients with clinically node-negative (cN0), solitary, isthmic PTC. METHODS: We retrospectively reviewed 73 consecutive patients who underwent surgery for solitary isthmic, PTC. The frequency, pattern, and risk factors of CLN metastasis were analyzed. RESULTS:Occult CLN metastasis and paratracheal lymph node (PTLN) metastasis were detected in 34 patients (46.6%) and 28 patients (38.4%), respectively. On multivariate logistic regression analysis, male sex and tumor size >0.7 cm were associated with CLN metastasis, and age ≤38 years, tumor size >0.6 cm, and pretracheal lymph node positivity were associated with PTLN metastasis. CONCLUSION: Thyroid isthmusectomy for solitary isthmic PTC may be insufficient in patients with tumors >0.6 cm, those aged ≤38 years, and male patients.
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
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