Pattern of Nodal Metastasis in Relation to Size of the Primary Tumour in Well-Differentiated Thyroid Carcinoma
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ORIGINAL ARTICLE
Pattern of Nodal Metastasis in Relation to Size of the Primary Tumour in Well-Differentiated Thyroid Carcinoma Rajjyoti Das1 • Tashnin Rahman1 • Ashok Kumar Das1 • Kishore Das1 Anupam Das1 • Kaberi Kakati1 • Rupjyoti Das1
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Received: 16 August 2020 / Accepted: 21 September 2020 Association of Otolaryngologists of India 2020
Abstract This study was conducted to see the pattern of neck node metastasis in relation to the size of primary tumour in Well-differentiated thyroid cancer. A prospective study on 50 patients was carried out in the Department of Head and Neck Surgery, Dr B. Borooah Cancer Institute from 1st August, 2018 to 31st July, 2019. All new cases who had not previously received treatment were included which were histopathogically proven. Residual and recurrent cases were not taken into account. Most common agegroup affected was 21–30 years (24%). It was more common in females (84%). Papillary thyroid cancer has been found to be the most common histological type of WDTC (88%), out of which the classical variant of PTC constitute 72%. 46% of them had tumour size [ 4 cm 88% cases had cervical neck node metastases, out of which 72% were unilateral and 16% were bilateral. The commonest level involved was level VI. There is a definite correlation (clinical and histological) between increased involvement of positivity of lymph node in relation to size of the primary tumour in well-differentiated thyroid carcinoma. Keywords Well-differentiated thyroid cancer Papillary thyroid cancer Classical variant Neck node
Introduction Well-differentiated thyroid cancers (WDTCs) are the most common endocrine malignancy. The incidence of thyroid cancer has been steadily increasing over the past three decades [1]. This increase is thought to represent the earlier detection of subclinical disease due to the increased use of screening ultrasound and ultrasound-guided fine-needle aspiration biopsy and autopsy. WDTCs are generally indolent tumours associated with low morbidity and mortality. Although 30-year disease-specific survival rates can exceed 95%, there is a subset of patients with metastatic disease where the 5-year survival can be as low as 56% [2]. Papillary thyroid carcinoma (PTC) frequently metastasizes to cervical lymph nodes, and a significant percentage of patients (up to 50–60% or even 90% for occult metastases) already have lymphatic spread at the time of diagnosis [28]. The risk of regional recurrence is higher in patients with lymph node metastases, especially in those with more than 10 involved nodes and with extracapsular extension and male patients more than 55 years. The presence of lymph node metastasis has also been shown to carry a poorer prognosis [9].
Aims and Objectives
& Rupjyoti Das [email protected] 1
Department of Head and Neck Surgery, B Borooah Cancer Institute, House No 10, Gopal Phukan Path, Ajanta Path, Beltola, Guwahati, Assam 781028, India
1. To look for the dimensions of the tumour 2. To see the pattern of neck node metastasis on the basis of the si
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