Multifocality is associated with central neck lymph node metastases in papillary thyroid microcarcinoma
Authors Zheng W, Wang K, Wu J, Wang W, Shang J
Received 20 January 2018
Accepted for publication 14 March 2018
Published 14 June 2018 Volume 2018:10 Pages 1527—1533
Checked for plagiarism Yes
Review by Single-blind
Peer reviewer comments 3
Editor who approved publication: Professor Lu-Zhe Sun
Weihui Zheng,1 Kejing Wang,1 Junzhou Wu,2 Wendong Wang,1 Jinbiao Shang1
1Department of Head & Neck Surgery Zhejiang Cancer Hospital and Key Laboratory of Head & Neck Cancer Translational Research of Zhejiang Province, Hangzhou, People’s Republic of China; 2Department of Cancer Research, Zhejiang Cancer Hospital, Hangzhou, People’s Republic of China
Background: This study aimed to assess the predictive factor of multifocality to identify patients at high risk of central lymph node metastasis (CLNM).
Patients and methods: Papillary thyroid microcarcinoma patients who underwent total or hemi-thyroidectomy with effective unilateral or bilateral central lymph node dissection were enrolled.
Results: Multifocality, age, sex, tumor size, extrathyroidal extension, and nodular goiter were significantly associated with CLNM. Multifocality was an independent predictor for CLNM in multivariate analysis. Compared with unifocal disease, the odds ratio for CLNM was 1.447 for patients with ≥2 tumor foci (P<0.001) and 2.978 for patients with ≥3 tumor foci (P<0.001). The significant association is at ≥3 foci diseases.
Conclusion: Multifocality with ≥3 tumor foci was an independent predictive factor for CLNM in papillary thyroid microcarcinoma. Multifocality should be assessed when selecting patients for prophylactic central neck lymph node dissection, and we speculate that patients with multifocality should undergo more radical treatment.
Keywords: papillary thyroid microcarcinoma, central compartment lymph node, multifocal, metastases, predictor
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