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논문KCI 등재

갑상선 유두암 T1, T2 병기 환자에서 중앙경부 림프절 전이의 빈도와 예측인자

Incidence and Predictive Factors of Central Neck Node Metastasis in Patients with T1, T2 Papillary Thyroid Cancer

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Purpose: Thyroidectomy without prophylactic central neck dissection may be recom-mended for small (T1 or T2) papillary thyroid carcinoma (PTC). The aim of this study was to determine the incidence and predictive factors of central cervical lymph node metastasis in T1/2 papillary thyroid carcinoma.Methods: A retrospective review of 877 patients with T1/2 PTC who underwent thyroidectomy and central lymph node dissection with or without lateral lymph node dissection from March 2007 to February 2014 was performed. The clinicopathologic results were reviewed and the incidence and predictive factors of central cervical lymph node metastasis (LNM) were analyzed.Results: The overall frequency of central LNM was 29.8%. In univariate analysis, male, younger age, bilaterality, multifocality, larger tumor size, lymphovascular invasion, and lateral lymph node metastasis were associated with central LNM. In multivariate analysis, younger age, larger tumor size, lymphovascular invasion, and lateral lymph node metastasis were independent variables of central LNM.Conclusion: Central LNM is associated with younger age, larger tumor, lymphovascular invasion, and lateral lymph node metastasis in small (T1/2) PTC patients. Prophylactic central lymph node dissection should be considered in patients with risk factors.

Abstract

Purpose: Thyroidectomy without prophylactic central neck dissection may be recom-mended for small (T1 or T2) papillary thyroid carcinoma (PTC). The aim of this study was to determine the incidence and predictive factors of central cervical lymph node metastasis in T1/2 papillary thyroid carcinoma.Methods: A retrospective review of 877 patients with T1/2 PTC who underwent thyroidectomy and central lymph node dissection with or without lateral lymph node dissection from March 2007 to February 2014 was performed. The clinicopathologic results were reviewed and the incidence and predictive factors of central cervical lymph node metastasis (LNM) were analyzed.Results: The overall frequency of central LNM was 29.8%. In univariate analysis, male, younger age, bilaterality, multifocality, larger tumor size, lymphovascular invasion, and lateral lymph node metastasis were associated with central LNM. In multivariate analysis, younger age, larger tumor size, lymphovascular invasion, and lateral lymph node metastasis were independent variables of central LNM.Conclusion: Central LNM is associated with younger age, larger tumor, lymphovascular invasion, and lateral lymph node metastasis in small (T1/2) PTC patients. Prophylactic central lymph node dissection should be considered in patients with risk factors.

참고문헌 (21)

  1. Chow SM, "Papillary microcarcinoma of the thyroid-Prognostic significance of lymph node metastasis and multifocality", Cancer, 98, pp.31~40 (2003)
  2. Gimm O, "Pattern of lymph node metastases in papillary thyroid carcinoma", Br J Surg, 85, pp.252~254 (1998)
  3. Noguchi M, "Bilateral cervical lymph node metastases in well-differentiated thyroid cancer", Arch Surg, 125, pp.804~806 (1990)
  4. Cooper DS, "Revised American Thyroid Association management guidelines for patients with thyroid nodules and differentiated thyroid cancer", Thyroid, 19, pp.1167~1214 (2009)
  5. Shindo M, "The importance of central compartment elective lymph node excision in the staging and treatment of papillary thyroid cancer", Arch Otolaryngol Head Neck Surg, 132, pp.650~654 (2006)
  6. Tisell LE, "Improved survival of patients with papillary thyroid cancer after surgical microdissection", World J Surg, 20, pp.854~859 (1996)
  7. Carty SE, "Consensus statement on the terminology and classification of central neck dissection for thyroid cancer", Thyroid, 19, pp.1153~1158 (2009)
  8. Chen AY, "Increasing incidence of differentiated thyroid cancer in the United States, 1988-2005", Cancer, 115, pp.3801~3807 (2009)
  9. Kilfoy BA, "International patterns and trends in thyroid cancer incidence, 1973-2002", Cancer Causes Control, 20, pp.525~531 (2009)
  10. Lundgren CI, "Clinically significant prognostic factors for differentiated thyroid carcinoma:a population-based, nested case-control study", Cancer, 106, pp.524~531 (2006)
  11. Mercante G, "Prognostic factors affecting neck lymph node recurrence and distant metastasis in papillary microcarcinoma of the thyroid: results of a study in 445 patients", Thyroid, 19, pp.707~716 (2009)
  12. McHenry CR, "Prospective management of nodal metastases in differentiated thyroid cancer", Am J Surg, 162, pp.353~356 (1991)
  13. Scheumann GF, "Prognostic significance and surgical management of locoregional lymph node metastases in papillary thyroid cancer", World J Surg, 18, pp.559~567 (1994)
  14. Hwang HS, "Efficacy of preoperative neck ultrasound in the detection of cervical lymph node metastasis from thyroid cancer", Laryngoscope, 121, pp.487~491 (2011)
  15. Ito Y, "Clinical significance of metastasis to the central compartment from papillary microcarcinoma of the thyroid", World J Surg, 30, pp.91~99 (2006)
  16. Mazzaferri EL, "The pros and cons of prophylactic central compartment lymph node dissection for papillary thyroid carcinoma", Thyroid, 19, pp.683~689 (2009)
  17. 이가희, "대한갑상선학회 갑상선결절 및 암 진료 권고안 개정안", 대한영상의학회지, 64(4), pp.389~416 (2011), 대한영상의학회
  18. Zhou YL, "Factors predictive of papillary thyroid micro-carcinoma with bilateral involvement and central lymph node metastasis: a retrospective study", World J Surg Oncol, 10, pp.67~ (2012)
  19. Henry JF, "Morbidity of prophylactic lymph node dissection in the central neck area in patients with papillary thyroid carcinoma", Langenbecks Arch Surg, 383, pp.167~169 (1998)
  20. Palestini N, "Is central neck dissection a safe procedure in the treatment of papillary thyroid cancer? Our experience", Langenbecks Arch Surg, 393, pp.693~698 (2008)
  21. Sywak M, "Routine ipsilateral level VI lymphadenectomy reduces postoperative thyroglobulin levels in papillary thyroid cancer", Surgery, 140, pp.1000~1005 (2006)

관련 논문AI추천

갑상선 유두미세암에서 중심 림프절 전이를 예측할 수 있는 인자에 관한 분석김이수, 김준호, 김해성, 안소은, 이강율, 이연옥, 임영아대한내분비외과학회 · Journal of Endocrine Surgery2012 · 제12권 제4호중심 경부 림프절 전이가 있는 갑상샘 유두암에서 전이 림프절 비율, 림프절 피막외 침범의 관련 인자 분석김성원, 박찬우, 송준웅, 이강대, 이형신, 천봉권, 홍종철대한이비인후과학회 · 대한이비인후과학회지 두경부외과학2015 · 제58권 제7호임상적으로 중심구역 림프절 전이가 의심되지 않는 환자에서 중심구역 림프절 절제술의 필요성에 대한 고찰공병호, 김동주, 박진우, 방승욱대한내분비외과학회 · Journal of Endocrine Surgery2016 · 제16권 제3호Factors Influencing Central Neck Lymph Node Metastasis in Patients with Papillary Thyroid Microcarcinoma김권천, 김영훈, 김유석대한내분비외과학회 · Journal of Endocrine Surgery2016 · 제16권 제3호측경부 전이 유두암 환자의 재발 위험인자 분석김보현, 김인주, 김총락, 신성찬, 이갑균, 이병주, 이정우, 이진춘, 장지원, 천용일대한이비인후과학회 · 대한이비인후과학회지 두경부외과학2022 · 제65권 제8호Predictive Factors for Central Neck Lymph Node Metastasis in Patients with Papillary Thyroid Microcarcinoma without Suspicious Metastasis by Preoperative Ultrasonography김권천, 김유석, 정수연대한내분비외과학회 · Journal of Endocrine Surgery2017 · 제17권 제3호

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