Preoperative Ultrasonography Predicts Level II Lymph Node Metastasis in N1b Papillary Thyroid Carcinoma: Implications for Surgical Planning.

Autor:	Eun NL; Department of Radiology, Thyroid Cancer Center, Gangnam Severance Hospital, Institute of Refractory Thyroid Cancer, Yonsei University College of Medicine, Gangnam-gu, Seoul 06273, Republic of Korea., Kim JA; Department of Radiology, Thyroid Cancer Center, Gangnam Severance Hospital, Institute of Refractory Thyroid Cancer, Yonsei University College of Medicine, Gangnam-gu, Seoul 06273, Republic of Korea., Lee Y; Department of Pathology, Thyroid Cancer Center, Gangnam Severance Hospital, Institute of Refractory Thyroid Cancer, Yonsei University College of Medicine, Gangnam-gu, Seoul 06273, Republic of Korea., Youk JH; Department of Radiology, Thyroid Cancer Center, Gangnam Severance Hospital, Institute of Refractory Thyroid Cancer, Yonsei University College of Medicine, Gangnam-gu, Seoul 06273, Republic of Korea., Yun HJ; Department of Surgery, Thyroid Cancer Center, Gangnam Severance Hospital, Institute of Refractory Thyroid Cancer, Yonsei University College of Medicine, Gangnam-gu, Seoul 06273, Republic of Korea., Chang H; Department of Surgery, Thyroid Cancer Center, Gangnam Severance Hospital, Institute of Refractory Thyroid Cancer, Yonsei University College of Medicine, Gangnam-gu, Seoul 06273, Republic of Korea., Kim SM; Department of Surgery, Thyroid Cancer Center, Gangnam Severance Hospital, Institute of Refractory Thyroid Cancer, Yonsei University College of Medicine, Gangnam-gu, Seoul 06273, Republic of Korea., Lee YS; Department of Surgery, Thyroid Cancer Center, Gangnam Severance Hospital, Institute of Refractory Thyroid Cancer, Yonsei University College of Medicine, Gangnam-gu, Seoul 06273, Republic of Korea., Chang HS; Department of Surgery, Thyroid Cancer Center, Gangnam Severance Hospital, Institute of Refractory Thyroid Cancer, Yonsei University College of Medicine, Gangnam-gu, Seoul 06273, Republic of Korea., Yang H; Biostatistics Collaboration Unit, Yonsei University College of Medicine, Gangnam-gu, Seoul 06273, Republic of Korea., Jeon S; Biostatistics Collaboration Unit, Yonsei University College of Medicine, Gangnam-gu, Seoul 06273, Republic of Korea., Son EJ; Department of Radiology, Thyroid Cancer Center, Gangnam Severance Hospital, Institute of Refractory Thyroid Cancer, Yonsei University College of Medicine, Gangnam-gu, Seoul 06273, Republic of Korea.
Jazyk:	angličtina
Zdroj:	Biomedicines [Biomedicines] 2024 Jul 17; Vol. 12 (7). Date of Electronic Publication: 2024 Jul 17.
DOI:	10.3390/biomedicines12071588
Abstrakt:	Purpose: To investigate whether preoperative ultrasonographic (US) features of the index cancer and metastatic lymph nodes (LNs) are associated with level II LN metastasis in N1b papillary rmfthyroid carcinoma (PTC) patients. Materials and Methods: We enrolled 517 patients (mean age, 42 [range, 6-80] years) who underwent total thyroidectomy and lateral compartment LN dissection between January 2009 and December 2015. We reviewed the clinicopathologic and US features of the index cancer and metastatic LNs in the lateral neck. Logistic regression analysis was performed to analyze features associated with level II LN metastasis. Results: Among the patients, 196 (37.9%) had level II metastasis on final pathology. In the preoperative model, larger tumor size (odds ratios [ORs], 1.031; 95% confidence interval [CI]: 1.011-1.051, p = 0.002), nonparallel tumor shape (OR, 1.963; 95% CI: 1.322-2.915, p = 0.001), multilevel LN involvement (OR, 1.906; 95% CI: 1.242-2.925, p = 0.003), and level III involvement (OR, 1.867; 95% CI: 1.223-2.850, p = 0.004), were independently associated with level II LN metastasis. In the postoperative model, non-conventional pathology remained a significant predictor for level II LN metastasis (OR, 1.951; 95% CI: 1.121-3.396; p = 0.018), alongside the presence of extrathyroidal extension (OR, 1.867; 95% CI: 1.060-3.331; p = 0.031), and higher LN ratio (OR, 1.057; 95% CI: 1.039-1.076; p < 0.001). Conclusions: Preoperative US features of the index tumor and LN may be helpful in guiding surgery in N1b PTC. These findings could enhance preoperative planning and decision-making, potentially reducing surgical morbidities by identifying those at higher risk of level II LN metastasis and tailoring surgical approaches accordingly.
Databáze:	MEDLINE
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