Predictive Risk Factors for Recurrence or Metastasis in Papillary Thyroid Cancer
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Background and Objectives: This study investigated predictive risk factors for cervical nodal recurrence ormetastasis in papillary thyroid carcinoma (PTC). Materials and Methods: From September 2014 to February 2015,a total of 321 PTC patients were enrolled retrospectively. Except for 154 N0 patients, the remaining 167 patientswere divided into two groups as follows: Group I (n=140), central lymph node (LN) metastasis (pN1a); GroupII (n=27), lateral LN metastasis (pN1b, n=23) or LN recurrence (n=4). The patients who had LN metastasis orrecurrence underwent selective LN dissection or recurrent LN excision. Results: Central LN metastases were foundin 44.0% (142/321) of patients. Two hundred thirty patients (71.7%) were classified as being at low-risk forLN disease, as evidenced by N0 or fewer than five micrometastases. The mean size of central metastatic LNs was0.37±0.34 cm. A total of 76 patients (46.6%) presented with micrometastasis, and ten (3.1%) presented withextranodal extension (ENE). The multiple/bilateral cancer, Extrathyroidal extension, size of metastatic LN, ENE, highrisk LN disease (＞5, macrometastasis, ＞3.0 cm) and high thyroglobulin were significant risk factors in predictingLN recurrence or lateral LN metastasis (p＜0.05) in univariate analysis. Patients with ENE were 10.3 times moreat risk for recurrence or metastasis than patients without ENE. Conclusion: We consider the ENE was the mostpotent risk factors for LN recurrence or lateral LN metastasis in PTC.
Abstract
Background and Objectives: This study investigated predictive risk factors for cervical nodal recurrence ormetastasis in papillary thyroid carcinoma (PTC). Materials and Methods: From September 2014 to February 2015,a total of 321 PTC patients were enrolled retrospectively. Except for 154 N0 patients, the remaining 167 patientswere divided into two groups as follows: Group I (n=140), central lymph node (LN) metastasis (pN1a); GroupII (n=27), lateral LN metastasis (pN1b, n=23) or LN recurrence (n=4). The patients who had LN metastasis orrecurrence underwent selective LN dissection or recurrent LN excision. Results: Central LN metastases were foundin 44.0% (142/321) of patients. Two hundred thirty patients (71.7%) were classified as being at low-risk forLN disease, as evidenced by N0 or fewer than five micrometastases. The mean size of central metastatic LNs was0.37±0.34 cm. A total of 76 patients (46.6%) presented with micrometastasis, and ten (3.1%) presented withextranodal extension (ENE). The multiple/bilateral cancer, Extrathyroidal extension, size of metastatic LN, ENE, highrisk LN disease (＞5, macrometastasis, ＞3.0 cm) and high thyroglobulin were significant risk factors in predictingLN recurrence or lateral LN metastasis (p＜0.05) in univariate analysis. Patients with ENE were 10.3 times moreat risk for recurrence or metastasis than patients without ENE. Conclusion: We consider the ENE was the mostpotent risk factors for LN recurrence or lateral LN metastasis in PTC.
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