Risk factors for lymph node metastasis in papillary thyroid microcarcinoma: Older patients with fewer lymph node metastases
| Autor: | Yongtai Liu, Yexiong Li, Jiaxin Yang, Qiuning Sun, Lin Zhang, Zhengyin Liu, Zhonghua Shang, Xuemei Li, Shi Chen, Ge Chen, Feng Liang |
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| Rok vydání: | 2016 |
| Předmět: |
Adult
Male medicine.medical_specialty Pathology medicine.medical_treatment 030209 endocrinology & metabolism Lower risk Gastroenterology Group B 03 medical and health sciences 0302 clinical medicine Risk Factors Internal medicine medicine Humans Thyroid Neoplasms Risk factor Chronic thyroiditis Lymph node Aged business.industry Age Factors Neck dissection General Medicine Odds ratio Middle Aged Carcinoma Papillary medicine.anatomical_structure Oncology Lymphatic Metastasis 030220 oncology & carcinogenesis Female Surgery Lymph business |
| Zdroj: | European Journal of Surgical Oncology (EJSO). 42:1478-1482 |
| ISSN: | 0748-7983 |
| DOI: | 10.1016/j.ejso.2016.07.002 |
| Popis: | Background Lymph node metastasis (LNM) is an important consideration in treatment strategy selection for papillary thyroid microcarcinoma (PTMC). The aim of this study was to investigate the risk factors for LNM and high-volume LNM (hvLNM, >5 metastatic lymph nodes). Methods A consecutive series of 1226 PTMC (947 female, 279 male) patients was reviewed. All patients underwent at least central neck dissection. Clinical-pathological features were assessed. All patients were allocated into Group A (≤39 yrs), Group B (40–59 yrs), or Group C (≥60 yrs) for risk factor analysis. Results Among all patients, 438 LNM and 73 hvLNM were detected. Older patients had significantly fewer LNM (A: 51.45% of 346, B: 30.15% of 786, and C: 24.47% of 94) and fewer hvLNM (A: 11.85%, B: 3.94%, and C: 1.06%). Male, multifocality, and tumor diameter >0.5 cm were also correlated with LNM and hvLNM. In multivariate analysis, older patients had lower risk of LNM (odds ratio [OR] 0.389 in B, 0.305 in C), and chronic thyroiditis was protective factor for LNM (OR 0.524). Male (OR 1.651), tumor diameter >0.5 cm (OR 1.850), and multifocality (OR 1.928) were risk factors for LNM. Similarly, older patients had lower risk of hvLNM (OR 0.313 in B, OR 0.085 in C). Male (OR 2.590), tumor diameter >0.5 cm (OR 2.180), and multifocality (OR 1.980) were also risk factors for hvLNM. Conclusion Older PTMC patients may have fewer LNM and lower risk of hvLNM. For patients ≥60 years old, dynamic observation may be an option for clinical management. |
| Databáze: | OpenAIRE |
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