Clinical and sonographic features for the preoperative prediction of lymph nodes posterior to the right recurrent laryng
- PDF / 876,547 Bytes
- 7 Pages / 595.276 x 790.866 pts Page_size
- 37 Downloads / 178 Views
ORIGINAL ARTICLE
Clinical and sonographic features for the preoperative prediction of lymph nodes posterior to the right recurrent laryngeal nerve metastasis in patients with papillary thyroid carcinoma M. Zou1 · Y. H. Wang1 · Y. F. Dong1 · X. J. Lai1 · J. C. Li1 Received: 24 January 2020 / Accepted: 23 March 2020 © Italian Society of Endocrinology (SIE) 2020
Abstract Objective To evaluate clinical and sonographic features predictive of lymph nodes posterior to the right recurrent laryngeal nerve (LN-prRLN) metastasis in patients diagnosed with papillary thyroid carcinoma (PTC). Methods We retrospectively reviewed the clinical records and ultrasound (US) images of 479 consecutive PTC patients who received total thyroidectomy or right lobectomy with central neck dissection (CND) between October 2017 and October 2019. Univariate and multivariate analyses were performed to identify clinical and sonographic features associated with LN-prRLN metastasis. Receiver operating characteristic (ROC) analysis was applied to evaluate the efficacy of clinical and sonographic features in the preoperative prediction of LN-prRLN metastasis. Results Overall, 127 (26.5%) patients had LN-prRLN metastasis. Multivariate logistic regression analysis showed that age 1 cm (p = 0.042; OR 1.702; 95% CI 1.019–2.842), microcalcifications (p = 0.022; OR 1.980; 95% CI 1.104–3.551), and US-detected lateral compartment lymph node (LLN) metastasis (p = 0.001; OR 2.578; 95% CI 1.500–4.430) were independent risk factors for LN-prRLN metastasis. ROC analysis revealed that the multivariate logistic regression model had good accuracy in predicting LN-prRLN metastasis, with an area under the ROC curve of 0.758. Conclusions Age less than 45 years, male sex, tumor diameter larger than 1 cm, microcalcifications, and US-detected LLN metastasis may preoperatively predict LN-prRLN metastasis. Keywords Papillary thyroid carcinoma · Ultrasonography · Lymph nodes posterior to the right recurrent laryngeal nerve metastasis
Introduction Thyroid cancer with papillary thyroid carcinoma (PTC), the most common histologic type, is a common disease with increasing occurrence and mortality rates [1]. PTC is a relatively indolent disease and has an excellent prognosis, with a 10-year survival rate of more than 90% [2]. In contrast to its favorable prognosis, PTC is prone to metastasize * X. J. Lai [email protected] * J. C. Li [email protected] 1
Department of Ultrasound, Peking Union Medical College Hospital, 1 Shuaifuyuan, Dongcheng District, Beijing 100730, China
to the cervical lymph nodes, particularly the central compartment lymph nodes (CLNs), affecting 20–90% of PTC patients [3]. The presence of lymph node metastasis (LNM) results in an increased locoregional recurrence rate [4, 5] and a reduction in the postoperative survival rate in older patients [6]. According to a consensus statement [7], CLNs are subdivided into the Delphian lymph nodes, right and left paratracheal lymph nodes and pretracheal lymph nodes. The anatomies of the right and left
Data Loading...
