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

Research output: Contribution to journalArticle

71 Citations (Scopus)

Abstract

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.

Original languageEnglish
Pages (from-to)1348-1355
Number of pages8
JournalAnnals of surgical oncology
Volume16
Issue number5
DOIs
Publication statusPublished - 2009 May 1

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Neck
Lymph Nodes
Neoplasm Metastasis
Capsules
Calcinosis
Papillary Thyroid Microcarcinoma
Clinical Pathology
Cohort Studies
Multivariate Analysis
Retrospective Studies
Recurrence

All Science Journal Classification (ASJC) codes

  • Surgery
  • Oncology

Cite this

Kwak, Jin Young ; Kim, Eun Kyung ; Kim, Min Jung ; Son, Eun Ju ; Chung, Woong Youn ; Park, Cheong Soo ; Nam, Kee Hyun. / Papillary microcarcinoma of the thyroid : Predicting factors of lateral neck node metastasis. In: Annals of surgical oncology. 2009 ; Vol. 16, No. 5. pp. 1348-1355.
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title = "Papillary microcarcinoma of the thyroid: Predicting factors of lateral neck node metastasis",
abstract = "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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Papillary microcarcinoma of the thyroid : Predicting factors of lateral neck node metastasis. / Kwak, Jin Young; Kim, Eun Kyung; Kim, Min Jung; Son, Eun Ju; Chung, Woong Youn; Park, Cheong Soo; Nam, Kee Hyun.

In: Annals of surgical oncology, Vol. 16, No. 5, 01.05.2009, p. 1348-1355.

Research output: Contribution to journalArticle

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T1 - Papillary microcarcinoma of the thyroid

T2 - Predicting factors of lateral neck node metastasis

AU - Kwak, Jin Young

AU - Kim, Eun Kyung

AU - Kim, Min Jung

AU - Son, Eun Ju

AU - Chung, Woong Youn

AU - Park, Cheong Soo

AU - Nam, Kee Hyun

PY - 2009/5/1

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N2 - 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.

AB - 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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