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Inicio Acta Otorrinolaringológica Española Clinicopathologic Predictive Factors of Cervical Lymph Node Metastasis in Differ...
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Vol. 69. Issue 3.
Pages 149-155 (May - June 2018)
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Vol. 69. Issue 3.
Pages 149-155 (May - June 2018)
Original article
DOI: 10.1016/j.otoeng.2017.06.015
Clinicopathologic Predictive Factors of Cervical Lymph Node Metastasis in Differentiated Thyroid Cancer
Factores clinicopatológicos predictivos de metástasis ganglionares cervicales en el cáncer de tiroides diferenciado
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Ronghao Suna,1, Hua Zhangb,1, Kun Liua, Jinchuan Fana, Guojun Lic,d, Xicheng Songb,
Corresponding author
songxicheng@126.com

Corresponding author.
, Chao Lia,
Corresponding author
headneck@qq.com

Corresponding author.
a Department of Head and Neck Surgery, Sichuan Cancer Hospital, Chengdu, China
b Department of Otolaryngology-Head and Neck Surgery, the Affiliated Yuhuangding Hospital of Qingdao University, Yantai, China
c Department of Head and Neck Surgery
d Epidemiology, University of Texas MD Anderson Cancer Center, Houston, TX 77030, USA
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Tables (2)
Table 1. Univariate Analysis of Clinicopathologic Characteristics Related to Central and Lateral LNM.
Table 2. Multivariate logistic regression analysis for central and lateral LNM.
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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.

Keywords:
Differentiated thyroid carcinoma
Cervical lymph node
Metastasis
Neck lymph node dissection
Abbreviations:
DTC
LNM
LND
PLND
NCCN
Resumen
Antecedentes

Las metástasis ganglionares cervicales (LNM) han demostrado ser un factor predictivo de recidiva locorregional en el cáncer de tiroides diferenciado (DTC). Las características clinicopatológicas podrían ser factores predictivos efectivos para LNM central y lateral en el DTC, y aportar referencias a los cirujanos de cara a la disección de los ganglios del cuello.

Mèc)todos

Análisis retrospectivo de datos clinicopatológicos realizado en 420 pacientes sometidos a cirugía inicial desde 2010 a 2015.

Resultados

Se calculó la incidencia de las LNM centrales y laterales. De los 420 pacientes, 247 (58,8%) reflejaron LNM central y 185 (44,1%) LNM lateral. Se produjeron 29 (6,9%) casos confirmados de metástasis discontinuas. El análisis univariante y multivariante reveló que la localización, el tamaño del tumor, la multifocalidad, la invasión capsular, los lóbulos afectados y la edad eran factores predictivos independientes de la LNM central. La localización tumoral, la invasión capsular, los lóbulos afectados y el tamaño del tumor eran factores predictivos independientes de la LNM lateral.

Conclusiones

Nuestros hallazgos indican que la localización tumoral, los lóbulos afectados, la invasión capsular, la edad, el tamaño del tumor y la multifocalidad pueden considerarse factores predictivos para la LNM cervical de DTC. La evaluación meticulosa perioperativa de la LNM cervical y la disección profiláctica de los ganglios cervicales, cuyo objetivo es extirpar los ganglios ocultos, puede ser una opción para el DTC con factores de riesgo.

Palabras clave:
Cáncer de tiroides diferenciado
Ganglio cervical
Metástasis
Disección de ganglios del cuello

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