Ronghao Sun1, Hua Zhang2, Kun Liu1, Jinchuan Fan1, Guojun Li3, Xicheng Song4, Chao Li5. 1. Department of Head and Neck Surgery, Sichuan Cancer Hospital, Chengdu, China. 2. Department of Otolaryngology-Head and Neck Surgery, the Affiliated Yuhuangding Hospital of Qingdao University, Yantai, China. 3. Department of Head and Neck Surgery; Epidemiology, University of Texas MD Anderson Cancer Center, Houston, TX 77030, USA. 4. Department of Otolaryngology-Head and Neck Surgery, the Affiliated Yuhuangding Hospital of Qingdao University, Yantai, China. Electronic address: songxicheng@126.com. 5. Department of Head and Neck Surgery, Sichuan Cancer Hospital, Chengdu, China. Electronic address: headneck@qq.com.
Abstract
BACKGROUND: Cervical lymph node metastasis (LNM) has been proven to be a predictor for locoregional recurrence in differentiated thyroid carcinoma (DTC). Clinicopathological features could be effective predictive factors for central and lateral LNM of DTC, and provide references to surgeons for cervical neck dissection. METHODS: Retrospective analysis of clinicopathological data was performed on 420 patients who underwent initial surgery from 2010 to 2015. RESULTS: The incidence of central and lateral LNM was calculated. Of 420 patients, 247 (58.8%) exhibited central LNM, and 185 (44.1%) exhibited lateral LNM. There were 29 (6.9%) cases confirmed to have skip metastasis. Univariate and multivariate analysis revealed that tumour location, tumour size, multifocality, capsular invasion, affected lobes, and age were independent predictors of central LNM. Tumour location, capsular invasion, affected lobes, and tumour size were independent predictors of lateral LNM. CONCLUSIONS: Our findings suggest that tumour location, affected lobes, capsular invasion, age, tumour size and multifocality may be taken as predictive factors for cervical LNM of DTC. Meticulous perioperative evaluation of cervical LNM and prophylactic cervical lymph node dissection that aims to remove the occult lymph nodes may be an option for DTC with risk factors.
BACKGROUND: Cervical lymph node metastasis (LNM) has been proven to be a predictor for locoregional recurrence in differentiated thyroid carcinoma (DTC). Clinicopathological features could be effective predictive factors for central and lateral LNM of DTC, and provide references to surgeons for cervical neck dissection. METHODS: Retrospective analysis of clinicopathological data was performed on 420 patients who underwent initial surgery from 2010 to 2015. RESULTS: The incidence of central and lateral LNM was calculated. Of 420 patients, 247 (58.8%) exhibited central LNM, and 185 (44.1%) exhibited lateral LNM. There were 29 (6.9%) cases confirmed to have skip metastasis. Univariate and multivariate analysis revealed that tumour location, tumour size, multifocality, capsular invasion, affected lobes, and age were independent predictors of central LNM. Tumour location, capsular invasion, affected lobes, and tumour size were independent predictors of lateral LNM. CONCLUSIONS: Our findings suggest that tumour location, affected lobes, capsular invasion, age, tumour size and multifocality may be taken as predictive factors for cervical LNM of DTC. Meticulous perioperative evaluation of cervical LNM and prophylactic cervical lymph node dissection that aims to remove the occult lymph nodes may be an option for DTC with risk factors.