Predictive Risk Factors for Recurrence or Metastasis in Papillary Thyroid Cancer
김완욱, 이지연, 정진향, 박호용, 정지윤, 박지영, Tufano Ralph P.,
소속 상세정보
김완욱 ( Kim Wan-Wook )
Kyungpook National University School of Medicine Department of Surgery
이지연 ( Lee Jee-Yeon )
Kyungpook National University School of Medicine Department of Surgery
정진향 ( Jung Jin-Hyang )
Kyungpook National University School of Medicine Department of Surgery
박호용 ( Park Ho-Yong )
Kyungpook National University School of Medicine Department of Surgery
정지윤 ( Jeong Ji-Yun )
Kyungpook National University School of Medicine Department of Pathology
박지영 ( Park Ji-Young )
Kyungpook National University School of Medicine Department of Pathology
( Tufano Ralph P. )
Johns Hopkins University School of Medicine Department of Otolaryngology-Head and Neck Surgery
Abstract
Background and Objectives: This study investigated predictive risk factors for cervical nodal recurrence or metastasis in papillary thyroid carcinoma (PTC).
Materials and Methods: From September 2014 to February 2015, a total of 321 PTC patients were enrolled retrospectively. Except for 154 N0 patients, the remaining 167 patients were divided into two groups as follows: Group I (n=140), central lymph node (LN) metastasis (pN1a); Group II (n=27), lateral LN metastasis (pN1b, n=23) or LN recurrence (n=4). The patients who had LN metastasis or recurrence underwent selective LN dissection or recurrent LN excision.
Results: Central LN metastases were found in 44.0% (142/321) of patients. Two hundred thirty patients (71.7%) were classified as being at low-risk for LN disease, as evidenced by N0 or fewer than five micrometastases. The mean size of central metastatic LNs was 0.37±0.34 cm. A total of 76 patients (46.6%) presented with micrometastasis, and ten (3.1%) presented with extranodal extension (ENE). The multiple/bilateral cancer, Extrathyroidal extension, size of metastatic LN, ENE, high risk LN disease (＞5, macrometastasis, ＞3.0 cm) and high thyroglobulin were significant risk factors in predicting LN recurrence or lateral LN metastasis (p<0.05) in univariate analysis. Patients with ENE were 10.3 times more at risk for recurrence or metastasis than patients without ENE.
Conclusion: We consider the ENE was the most potent risk factors for LN recurrence or lateral LN metastasis in PTC.
키워드
Metastasis; Papillary thyroid cancer; Recurrence; Risk factors
원문 및 링크아웃 정보
등재저널 정보