Central nodal metastases in papillary thyroid carcinoma based on tumor histologic type and focality

Kelli D. Salter, Peter Andersen, James Cohen, Kathryn Schuff, Linda Lester, Maisie Shindo, David Sauer, Neil D. Gross

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28 Citations (Scopus)

Abstract

Objective: To determine the risk of nodal metastases to the central compartment from differentiated papillary thyroid carcinoma (PTC) relative to known prognostic variables. Design: A 7-year single-institutional retrospective review. Setting: Tertiary academic center. Patients: A total of 115 patients undergoing central neck dissection (CND) for PTC or follicular variant PTC (FVPTC). Main Outcome Measure: Number, location, and positivity of lymph nodes for malignant disease in the central compartment based on patient age, sex, extrathyroidal extension, and primary tumor size, histologic type, and focality. Results: Eighty-seven percent of patients had PTC, and 13% had FVPTC. Bilateral (64%) or ipsilateral (36%)CND was performed in patients with PTC. Patients with FVPTC underwent only ipsilateral CND. There was no significant difference in the number of lymph nodes retrieved based on patient age or sex, histologic type of the primary tumor, size or focality, or surgeon or pathologist. Seventy-eight percent of patients with PTC had malignant lymph nodes in the ipsilateral (75%) or bilateral/ contralateral (69%) central compartment. Ipsilateral nodal metastases directly correlated with tumor multifocality (r=0.93; P=.001) and size (r=0.89; P=.001). Bilateral nodal metastases directly correlated with tumor multifocality (r=0.92; P=.001) but was independent of size (r = 0.56; P=.001). No malignant lymph nodes were identified in the central compartment of FVPTC. Conclusions: Malignant central nodal metastases occur with high frequency in PTC but not in FVPTC. The risk of metastases correlated with the size and multifocality of the primary tumor. Additional studies are warranted to determine the extent of CND in patients with and without known multifocal disease and to determine the role of CND in patients with FVPTC.

Original languageEnglish (US)
Pages (from-to)692-696
Number of pages5
JournalArchives of Otolaryngology - Head and Neck Surgery
Volume136
Issue number7
DOIs
StatePublished - Jul 2010

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Neoplasm Metastasis
Factor IX
Neck Dissection
Neoplasms
Lymph Nodes
Papillary Thyroid cancer
Outcome Assessment (Health Care)

ASJC Scopus subject areas

  • Otorhinolaryngology
  • Surgery

Cite this

@article{972e92a3755340d0ae842e00897d0d45,
title = "Central nodal metastases in papillary thyroid carcinoma based on tumor histologic type and focality",
abstract = "Objective: To determine the risk of nodal metastases to the central compartment from differentiated papillary thyroid carcinoma (PTC) relative to known prognostic variables. Design: A 7-year single-institutional retrospective review. Setting: Tertiary academic center. Patients: A total of 115 patients undergoing central neck dissection (CND) for PTC or follicular variant PTC (FVPTC). Main Outcome Measure: Number, location, and positivity of lymph nodes for malignant disease in the central compartment based on patient age, sex, extrathyroidal extension, and primary tumor size, histologic type, and focality. Results: Eighty-seven percent of patients had PTC, and 13{\%} had FVPTC. Bilateral (64{\%}) or ipsilateral (36{\%})CND was performed in patients with PTC. Patients with FVPTC underwent only ipsilateral CND. There was no significant difference in the number of lymph nodes retrieved based on patient age or sex, histologic type of the primary tumor, size or focality, or surgeon or pathologist. Seventy-eight percent of patients with PTC had malignant lymph nodes in the ipsilateral (75{\%}) or bilateral/ contralateral (69{\%}) central compartment. Ipsilateral nodal metastases directly correlated with tumor multifocality (r=0.93; P=.001) and size (r=0.89; P=.001). Bilateral nodal metastases directly correlated with tumor multifocality (r=0.92; P=.001) but was independent of size (r = 0.56; P=.001). No malignant lymph nodes were identified in the central compartment of FVPTC. Conclusions: Malignant central nodal metastases occur with high frequency in PTC but not in FVPTC. The risk of metastases correlated with the size and multifocality of the primary tumor. Additional studies are warranted to determine the extent of CND in patients with and without known multifocal disease and to determine the role of CND in patients with FVPTC.",
author = "Salter, {Kelli D.} and Peter Andersen and James Cohen and Kathryn Schuff and Linda Lester and Maisie Shindo and David Sauer and Gross, {Neil D.}",
year = "2010",
month = "7",
doi = "10.1001/archoto.2010.112",
language = "English (US)",
volume = "136",
pages = "692--696",
journal = "JAMA Otolaryngology - Head and Neck Surgery",
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TY - JOUR

T1 - Central nodal metastases in papillary thyroid carcinoma based on tumor histologic type and focality

AU - Salter, Kelli D.

AU - Andersen, Peter

AU - Cohen, James

AU - Schuff, Kathryn

AU - Lester, Linda

AU - Shindo, Maisie

AU - Sauer, David

AU - Gross, Neil D.

PY - 2010/7

Y1 - 2010/7

N2 - Objective: To determine the risk of nodal metastases to the central compartment from differentiated papillary thyroid carcinoma (PTC) relative to known prognostic variables. Design: A 7-year single-institutional retrospective review. Setting: Tertiary academic center. Patients: A total of 115 patients undergoing central neck dissection (CND) for PTC or follicular variant PTC (FVPTC). Main Outcome Measure: Number, location, and positivity of lymph nodes for malignant disease in the central compartment based on patient age, sex, extrathyroidal extension, and primary tumor size, histologic type, and focality. Results: Eighty-seven percent of patients had PTC, and 13% had FVPTC. Bilateral (64%) or ipsilateral (36%)CND was performed in patients with PTC. Patients with FVPTC underwent only ipsilateral CND. There was no significant difference in the number of lymph nodes retrieved based on patient age or sex, histologic type of the primary tumor, size or focality, or surgeon or pathologist. Seventy-eight percent of patients with PTC had malignant lymph nodes in the ipsilateral (75%) or bilateral/ contralateral (69%) central compartment. Ipsilateral nodal metastases directly correlated with tumor multifocality (r=0.93; P=.001) and size (r=0.89; P=.001). Bilateral nodal metastases directly correlated with tumor multifocality (r=0.92; P=.001) but was independent of size (r = 0.56; P=.001). No malignant lymph nodes were identified in the central compartment of FVPTC. Conclusions: Malignant central nodal metastases occur with high frequency in PTC but not in FVPTC. The risk of metastases correlated with the size and multifocality of the primary tumor. Additional studies are warranted to determine the extent of CND in patients with and without known multifocal disease and to determine the role of CND in patients with FVPTC.

AB - Objective: To determine the risk of nodal metastases to the central compartment from differentiated papillary thyroid carcinoma (PTC) relative to known prognostic variables. Design: A 7-year single-institutional retrospective review. Setting: Tertiary academic center. Patients: A total of 115 patients undergoing central neck dissection (CND) for PTC or follicular variant PTC (FVPTC). Main Outcome Measure: Number, location, and positivity of lymph nodes for malignant disease in the central compartment based on patient age, sex, extrathyroidal extension, and primary tumor size, histologic type, and focality. Results: Eighty-seven percent of patients had PTC, and 13% had FVPTC. Bilateral (64%) or ipsilateral (36%)CND was performed in patients with PTC. Patients with FVPTC underwent only ipsilateral CND. There was no significant difference in the number of lymph nodes retrieved based on patient age or sex, histologic type of the primary tumor, size or focality, or surgeon or pathologist. Seventy-eight percent of patients with PTC had malignant lymph nodes in the ipsilateral (75%) or bilateral/ contralateral (69%) central compartment. Ipsilateral nodal metastases directly correlated with tumor multifocality (r=0.93; P=.001) and size (r=0.89; P=.001). Bilateral nodal metastases directly correlated with tumor multifocality (r=0.92; P=.001) but was independent of size (r = 0.56; P=.001). No malignant lymph nodes were identified in the central compartment of FVPTC. Conclusions: Malignant central nodal metastases occur with high frequency in PTC but not in FVPTC. The risk of metastases correlated with the size and multifocality of the primary tumor. Additional studies are warranted to determine the extent of CND in patients with and without known multifocal disease and to determine the role of CND in patients with FVPTC.

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U2 - 10.1001/archoto.2010.112

DO - 10.1001/archoto.2010.112

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