Bilateral Papillary Thyroid Cancer Increases the Risk of Lymph Node Metastasis Compared with Unilateral Multifocal Papillary Thyroid Cancer

한자령; 정진향; 김완욱; 이지연; 박호용; 김혜정; 박지영

추천

검색

자료유형: 학술저널

저자정보: 한자령 정진향 김완욱 이지연 박호용 김혜정 박지영

저널정보: 대한갑상선-내분비외과학회 The Journal of Endocrine Surgery The Journal of Endocrine Surgery 제17권 제2호

발행연도: 2017.1

수록면: 63 - 72 (10page)

이용수

📌

연구주제

📖

연구배경

🔬

연구방법

🏆

연구결과

초록· 키워드

오류제보하기

Purpose: Papillary thyroid cancer (PTC) has a strong propensity for lymph node metastasis, which is related with local recurrence, and disease-specific survival in the elderly. We evaluated the association between lymph node metastasis and disease multifocality, bilaterality, and other clinicopathological variables to identify risk factors and aid surgical decision-making. The relationship between the number of foci and metastasis to cervical lymph node was also evaluated. Methods: Patients with PTC (n=819) undergoing thyroidectomy at our institution were included. The study population was segregated into 4 groups based on PTC multifocality and bilaterality. Results: Cervical lymph node metastasis, tumor size, and tumor extent were significantly different between the study groups. The frequency of central and lateral cervical lymph node metastasis was the highest in the bilateral multifocal disease group, followed by the bilateral solitary group, unilateral multifocal group, and the unilateral solitary group. One PTC focus per thyroid lobe was associated with increased metastasis (53.8%). Moreover, lymph node positivity doubled with 5–7 foci (71.4%), and tripled with ≥8 foci (100.0%). Bilateral solitary and bilateral multifocal PTC were identified as independent predictors of cervical lymph node metastasis. Conclusion: Bilateral PTC was associated with lymph node positivity, which increased proportionally with the number of PTC foci. Bilateral solitary or multifocal PTC were associated with more aggressive features such as larger primary tumor size, more frequent extrathyroidal extensions, and regional lymph node metastasis. The presence of multiple bilateral foci or more than 3 foci are independent risk factors of lymph node metastases.

#Papillary thyroid cancer #Multifocal #Bilateral #Lymph node metastasis

참고문헌 (23)

참고문헌 신청

Edge SB / 2010 / The American Joint Committee on Cancer: the 7th edition of the AJCC Cancer Staging Manual and the future of TNM / Ann Surg Oncol 17 : 1471 ~ 1474

Hartl DM / 2012 / Optimization of staging of the neck with prophylactic central and lateral neck dissection for papillary thyroid carcinoma / Ann Surg 255 : 777 ~ 783

Haugen BR / 2016 / 2015 American Thyroid Association Management Guidelines for Adult Patients with Thyroid Nodules and Differentiated Thyroid Cancer: the American Thyroid As

Hay ID / 1992 / Papillary thyroid microcarcinoma: a study of 535 cases observed in a 50-year period / Surgery 112 : 1139 ~ 1146

Hughes DT / 2010 / Influence of prophylactic central lymph node dissection on postoperative thyroglobulin levels and radioiodine treatment in papillary thyroid cancer / Surge

함께 읽어보면 좋을 논문

논문 유사도에 따라 DBpia 가 추천하는 논문입니다. 함께 보면 좋을 연관 논문을 확인해보세요!