Factors predictive of papillary thyroid micro-carcinoma with bilateral involvement and central lymph node metastasis: a retrospective study
| Autor: | Er-li Gao, Han Yang, Yi-Li Zhou, Gui-Long Guo, Wei Zhang, Xiao-Hua Zhang, Ou-Chen Wang |
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| Rok vydání: | 2012 |
| Předmět: |
Male
Oncology medicine.medical_treatment Statistics as Topic Papillary micro-carcinoma Risk Factors Surgical oncology Odds Ratio Central lymph node metastasis Thyroid cancer medicine.diagnostic_test Thyroid Multifocality Middle Aged lcsh:Neoplasms. Tumors. Oncology. Including cancer and carcinogens Central lymph medicine.anatomical_structure Thyroid Cancer Papillary Lymphatic Metastasis Thyroidectomy Bilateral thyroid cancer Female Radiology Adult medicine.medical_specialty Biopsy Fine-Needle lcsh:Surgery lcsh:RC254-282 Young Adult Internal medicine Biopsy medicine Carcinoma Humans Thyroid Neoplasms Aged Retrospective Studies business.industry Research Retrospective cohort study lcsh:RD1-811 medicine.disease Carcinoma Papillary Logistic Models Multivariate Analysis Surgery business |
| Zdroj: | World Journal of Surgical Oncology World Journal of Surgical Oncology, Vol 10, Iss 1, p 67 (2012) |
| ISSN: | 1477-7819 |
| Popis: | Background The optimal resection extent for papillary thyroid microcarcinoma (PTMC) remains controversial. The objective of the study was to investigate risk factors of bilateral PTMC and central lymph node metastasis (CLNM) to guide surgical strategies for PTMC patients. Methods We retrospectively reviewed 211 PTMC patients who underwent total thyroidectomy (TT) and 122 clinical lymph node-negative (cN0) cases that underwent prophylactic central lymph node dissection (CLND) between 2010 and 2011. The frequency, pattern, and predictive factors for bilateral PTMC and CLNM in these patients were studied using univariate and multivariate analysis with respect to the following variables: age, gender, extrathyroidal extension (ETE), T stage, with Hashimoto thyroiditis (HT), tumor size and multifocality based on final pathology, and preoperative evaluation using ultrasonography (US). Results Fifty-four of 211 (25.6%) patients had bilateral PTMC. In multivariate analysis, multifocality (P P = 0.014, OR = 2.398) based on US were independent predictive factors for bilateral PTMC which was also independently associated with multifocality (P P = 0.005, OR = 2.863) based on final pathology. Among 122 cN0 patients who underwent prophylactic CLND, we found 49.2% of patients had CLNM. CLNM was independently associated with men, age Conclusions TT should be considered for PTMC patients who are found multifocality and tumor size ≥7 mm based on preoperative US. CLND need be considered in cN0 patients who are men, aged |
| Databáze: | OpenAIRE |
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