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Preoperative Prediction of Central Lymph Node Metastasis in Thyroid Papillary Microcarcinoma Using Clinicopathologic and Sonographic Features

Authors
 Kyung-Eun Kim  ;  Eun-Kyung Kim  ;  Jung Hyun Yoon  ;  Kyung Hwa Han  ;  Hee Jung Moon  ;  Jin Young Kwak 
Citation
 WORLD JOURNAL OF SURGERY, Vol.37(2) : 385-391, 2013 
Journal Title
 WORLD JOURNAL OF SURGERY 
ISSN
 0364-2313 
Issue Date
2013
MeSH
Adolescent ; Adult ; Aged ; Aged, 80 and over ; Carcinoma, Papillary/diagnostic imaging ; Carcinoma, Papillary/pathology* ; Carcinoma, Papillary/surgery ; Decision Support Techniques* ; Female ; Humans ; Logistic Models ; Lymphatic Metastasis ; Male ; Middle Aged ; Multivariate Analysis ; Neck Dissection ; Neoplasm Staging ; Odds Ratio ; Preoperative Care* ; Retrospective Studies ; Risk Factors ; Thyroid Neoplasms/diagnostic imaging ; Thyroid Neoplasms/pathology* ; Thyroid Neoplasms/surgery ; Thyroidectomy* ; Ultrasonography ; Young Adult
Keywords
Lymph Node Metastasis ; Thyroid Cancer ; Papillary Thyroid Carcinoma ; Large Tumor Size ; American Thyroid Association
Abstract
BACKGROUND: The purpose of the present study was to evaluate the clinicopathologic factors and ultrasound (US) features predictive of central lymph node metastasis (LNM) in patients diagnosed with papillary thyroid microcarcinoma (PTMC). METHODS: From March 2008 to August 2008, the clinicopathologic features and preoperative US features of 483 patients who were diagnosed with conventional PTMC were included. Medical records, US features, and pathology reports of all patients were retrospectively reviewed. Univariate and multivariate analysis was performed to identify clinicopathological prognostic factors associated with central LNM. Odds ratios (OR) with relative 95 % confidence intervals (95 % CI) were calculated to determine the relevance of all potential predictors of central LNM. RESULTS: Among the 483 patients with PTMC, 139 (28.8 %) patients had central LNM. The OR of significant independent factors were 2.055 (95 % CI, 1.137-3.716), 2.075 (95 % CI, 1.27-3.39), 1.71 (95 % CI, 1.073-2.724), and 15.897 (95 % CI, 4.173-60.569), respectively, for bilaterality, larger tumor size (>5 mm), extracapsular invasion, and lateral LNM. No significant association was seen among the US features of PTMC with central LNM. CONCLUSIONS: Central lymph node metastasis in patients with PTMC was significantly associated with various clinicopathological factors, including larger tumor size (>5 mm), bilaterality, extracapsular invasion, and lateral LNM. When these features are detected on preoperative US, selective central compartment dissection may be helpful in patients diagnosed with PTMC.
Full Text
http://link.springer.com/article/10.1007%2Fs00268-012-1826-3
DOI
10.1007/s00268-012-1826-3
Appears in Collections:
1. College of Medicine (의과대학) > Dept. of Radiology (영상의학교실) > 1. Journal Papers
1. College of Medicine (의과대학) > Yonsei Biomedical Research Center (연세의생명연구원) > 1. Journal Papers
Yonsei Authors
Kwak, Jin Young(곽진영) ORCID logo https://orcid.org/0000-0002-6212-1495
Kim, Kyung Eun(김경은)
Kim, Eun-Kyung(김은경) ORCID logo https://orcid.org/0000-0002-3368-5013
Moon, Hee Jung(문희정) ORCID logo https://orcid.org/0000-0002-5643-5885
Yoon, Jung Hyun(윤정현) ORCID logo https://orcid.org/0000-0002-2100-3513
Han, Kyung Hwa(한경화)
URI
https://ir.ymlib.yonsei.ac.kr/handle/22282913/86435
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