PMID- 37596455
OWN - NLM
STAT- MEDLINE
DCOM- 20240208
LR  - 20240209
IS  - 1559-0100 (Electronic)
IS  - 1355-008X (Linking)
VI  - 83
IP  - 2
DP  - 2024 Feb
TI  - Lateral lymph node metastasis in papillary thyroid microcarcinoma: a study of 
      5241 follow-up patients.
PG  - 414-421
LID - 10.1007/s12020-023-03486-5 [doi]
AB  - PURPOSE: To investigate the impact of lateral lymph node metastasis in papillary 
      thyroid microcarcinoma (PTMC). METHODS: 5241 PTMC patients with follow-up 
      information were enrolled in the current study. These patients underwent primary 
      surgery in our situation from January 1997 to December 2016. Additionally, a 
      validation cohort consisting of 274 PTMC patients who underwent primary surgery 
      between January 2020 and December 2021 was also included. Univariable and 
      multivariate logistic analyses were conducted to identify the association between 
      clinicopathologic features and lateral lymph node metastasis (LLNM). Kaplan-Meier 
      survival curve analysis was used to calculate the disease-free survival (DFS) 
      rate. The fitting curve was generated to identify the quantitative relationship 
      between central lymph node metastases (CLNM) and LLNM. RESULTS: Of 5241 PTMC 
      patients, cervical lymph node metastasis was detected in 1494 (28.5%) cases, 
      including 1364 (26.0%) with CLNM only and 130 (2.5%) with LLNM. With a median 
      follow-up time of 60 months (interquartile range [IQR], 44-81), recurrence was 
      detected in 114 patients (2.2%). Multivariate Cox regression analyses showed that 
      LNM was the only independent risk factor for recurrence, with HR values of 3.03 
      in CLNM and 11.14 in LLNM, respectively. Tumor diameter >0.5 cm (hazard ratio 
      [HR]:1.80), multifocality (HR:2.59), bilaterality (HR:2.13), extrathyroidal 
      invasion (HR:2.13), and CLNM (HR:5.11) were independent risk factors for LLNM. 
      The prevalence of LLNM escalated significantly with increasing number of lymph 
      node involvement in CLNM when stratified by the number of metastatic lymph nodes 
      and trend was observed similarly in the validation cohort. The fitting curve 
      showed that the incidence of LLNM could be as high as 20.7% when the number of 
      CLNM >/= 5. CONCLUSIONS: By analyzing a large database with follow-up information, 
      our study provides evidence that LLNM is significantly correlated with tumor 
      recurrence in patients with PTMC. Tumor size (>0.5 cm), multifocality, 
      bilaterality, extrathyroidal extension (ETE) and CLNM are independent risk 
      factors for LLNM.
CI  - (c) 2023. The Author(s), under exclusive licence to Springer Science+Business 
      Media, LLC, part of Springer Nature.
FAU - Ruan, Jiaying
AU  - Ruan J
AD  - Department of Surgical Oncology, First Affiliated Hospital, Zhejiang University 
      School of Medicine, Hangzhou, China.
FAU - Chen, Zhendong
AU  - Chen Z
AD  - Department of Surgical Oncology, First Affiliated Hospital, Zhejiang University 
      School of Medicine, Hangzhou, China.
FAU - Chen, Shitu
AU  - Chen S
AD  - Department of Surgical Oncology, First Affiliated Hospital, Zhejiang University 
      School of Medicine, Hangzhou, China.
FAU - Xu, Zehang
AU  - Xu Z
AD  - Department of Surgical Oncology, First Affiliated Hospital, Zhejiang University 
      School of Medicine, Hangzhou, China.
FAU - Wen, Liping
AU  - Wen L
AD  - Department of Surgical Oncology, First Affiliated Hospital, Zhejiang University 
      School of Medicine, Hangzhou, China.
FAU - Mao, Zhuochao
AU  - Mao Z
AD  - Department of Surgical Oncology, First Affiliated Hospital, Zhejiang University 
      School of Medicine, Hangzhou, China.
FAU - Shen, Jiejie
AU  - Shen J
AD  - Community Health Service Center, Jingjiang Street, Xiaoshan District, Hangzhou, 
      China.
FAU - Liu, Jian
AU  - Liu J
AD  - Department of Surgical Oncology, First Affiliated Hospital, Zhejiang University 
      School of Medicine, Hangzhou, China. liujianzy@zju.edu.cn.
FAU - Wang, Weibin
AU  - Wang W
AD  - Department of Surgical Oncology, First Affiliated Hospital, Zhejiang University 
      School of Medicine, Hangzhou, China. wbwang@zju.edu.cn.
LA  - eng
GR  - No. 81972495/National Natural Science Foundation of China/
PT  - Journal Article
DEP - 20230818
PL  - United States
TA  - Endocrine
JT  - Endocrine
JID - 9434444
RN  - Papillary Thyroid Microcarcinoma
SB  - IM
MH  - Humans
MH  - Lymphatic Metastasis/pathology
MH  - Follow-Up Studies
MH  - Retrospective Studies
MH  - *Neoplasm Recurrence, Local/pathology
MH  - *Thyroid Neoplasms/pathology
MH  - Lymph Nodes/pathology
MH  - Risk Factors
MH  - *Carcinoma, Papillary
OTO - NOTNLM
OT  - Lateral lymph node metastasis
OT  - Papillary thyroid microcarcinoma
OT  - Risk factors
OT  - prognosis
EDAT- 2023/08/19 11:42
MHDA- 2024/02/08 06:42
CRDT- 2023/08/18 23:30
PHST- 2023/03/21 00:00 [received]
PHST- 2023/08/07 00:00 [accepted]
PHST- 2024/02/08 06:42 [medline]
PHST- 2023/08/19 11:42 [pubmed]
PHST- 2023/08/18 23:30 [entrez]
AID - 10.1007/s12020-023-03486-5 [pii]
AID - 10.1007/s12020-023-03486-5 [doi]
PST - ppublish
SO  - Endocrine. 2024 Feb;83(2):414-421. doi: 10.1007/s12020-023-03486-5. Epub 2023 Aug 
      18.