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Papillary microcarcinoma of the thyroid: predicting factors of lateral neck node metastasis

 Jin Young Kwak  ;  Eun-Kyung Kim  ;  Min Jung Kim  ;  Eun Ju Son  ;  Woong Youn Chung  ;  Cheong Soo Park  ;  Kee-Hyun Nam 
 ANNALS OF SURGICAL ONCOLOGY, Vol.16(5) : 1348-1355, 2009 
Journal Title
Issue Date
Adenocarcinoma, Papillary/diagnostic imaging ; Adenocarcinoma, Papillary/pathology* ; Adenocarcinoma, Papillary/surgery ; Adolescent ; Adult ; Aged ; Cohort Studies ; Female ; Humans ; Lymph Node Excision ; Lymph Nodes/pathology* ; Lymphatic Metastasis ; Male ; Middle Aged ; Neck ; Neoplasm Recurrence, Local/prevention & control ; Prognosis ; Retrospective Studies ; Risk Factors ; Thyroid Neoplasms/diagnostic imaging ; Thyroid Neoplasms/pathology* ; Thyroid Neoplasms/surgery ; Ultrasonography ; Young Adult
Lymph Node Metastasis ; Thyroid Nodule ; Papillary Carcinoma ; Papillary Thyroid Cancer ; Pole Location
BACKGROUND: Preoperative prediction of lateral lymph node metastasis (LNM) is important to prevent recurrence; however, there are few published data in predicting factors of lateral LNM before surgery. The present study investigated the factors affecting LNM in patients with papillary thyroid microcarcinoma (PTMC).

METHODS: A retrospective cohort study was conducted with data obtained from 671 patients with PTMC between 2004 and 2006. We reviewed the clinical, ultrasound (US), and pathology records of patients and analyzed the association between lateral LNM and clinical factors, US features of PTMC, and pathologic features.

RESULTS: The rate of lateral LNM was 3.7% in 671 PTMCs. We found a statistically significant association between lateral LNM and US features of PTMC (upper pole location, contact of >25% with the adjacent capsule, and presence of calcifications), and pathologic features (central LNM) in multivariate analysis (P < .05). The odds ratios of statistically significant factors were 4.7 (95% confidence interval [95% CI], 1.8-12.6), 10.8 (95% CI, 3.3-34.6), 4.8 (95% CI, 1.6-13.7), and 6.9 (95% CI, 2.4-20) at upper pole location, contact of >25% with the adjacent capsule, presence of calcifications on US, and pathologic central LNM, respectively.

CONCLUSIONS: In patients with PTMC, independent factors in predicting lateral LNM were US features of PTMC (upper pole location, >25% contact with the adjacent capsule, and presence of calcifications) and pathologic features (central LNM). When these US features are detected on preoperative US, lateral neck nodes should be meticulously evaluated by a multimodal approach.
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1. College of Medicine (의과대학) > Dept. of Radiology (영상의학교실) > 1. Journal Papers
1. College of Medicine (의과대학) > Dept. of Surgery (외과학교실) > 1. Journal Papers
Yonsei Authors
Kwak, Jin Young(곽진영) ORCID logo https://orcid.org/0000-0002-6212-1495
Kim, Min Jung(김민정) ORCID logo https://orcid.org/0000-0003-4949-1237
Kim, Eun-Kyung(김은경) ORCID logo https://orcid.org/0000-0002-3368-5013
Nam, Kee Hyun(남기현) ORCID logo https://orcid.org/0000-0002-6852-1190
Park, Cheong Soo(박정수)
Son, Eun Ju(손은주) ORCID logo https://orcid.org/0000-0002-7895-0335
Chung, Woong Youn(정웅윤)
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