The total number of prelaryngeal and pretracheal lymph node metastases: is it a reliable predictor of contralateral central lymph node metastasis in papillary thyroid carcinoma?
The total number of prelaryngeal and pretracheal lymph node metastases: is it a reliable predictor of contralateral central lymph node metastasis in papillary thyroid carcinoma?
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DOI：
10.1016/j.jss.2015.02.056
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发表时间：
2017-06-15
影响因子：
2.2
通讯作者：
Zhu, Jing-qiang
中科院分区：
文献类型：
--
作者：
Chen, Qiang;Wei, Tao;Zhu, Jing-qiang
背景资料：甲状腺乳头状癌（PTC）的中央淋巴结（CLN）转移很常见，能够预测CLN转移有助于外科医生确定个性化治疗。然而，对侧CLN转移与喉前和气管前区阳性淋巴结（LN）总数之间的关系尚不清楚。本研究的目的是探讨是否在联合喉前和气管前区的阳性淋巴结的总数有临床意义的预测对侧CLN metastasis.Methods：我们前瞻性地纳入了153例连续的患者，单灶PTC > 1.0 cm，没有淋巴结转移的超声检查证据，从2011年7月至2013年5月接受甲状腺全切除术和预防性双侧CLN清扫。结果：PTC直径> 1.0cm者，同侧和对侧中央室转移率分别为84.3%和24.2%;多因素分析显示，喉前和气管前区域≥ 3个阳性淋巴结是对侧CLN转移的独立预测因素（P < 0.001;比值比8.585）。平均随访24.1个月后，这些患者均无中央或外侧compartment.Conclusions复发：隐匿性转移是非常普遍的，在同侧中央颈部的PTC > 1.0 cm的患者，喉前和气管前淋巴结转移的总数可能是一个有用的指标，以预测对侧CLN转移的单灶性PTC患者。(C)2015 Elsevier Inc. All rights reserved.
Background: Central lymph node (CLN) metastasis in papillary thyroid carcinoma (PTC) is common and being able to predict CLN metastasis helps surgeons determine individualized therapy. However, the relationship between contralateral CLN metastasis and the total number of positive lymph nodes (LNs) in the combined prelaryngeal and pretracheal region remains unclear. This study aimed to investigate whether the total number of positive LNs in the combined prelaryngeal and pretracheal region has clinical significance as a predictor for contralateral CLN metastasis.Methods: We prospectively enrolled 153 consecutive patients with unifocal PTC > 1.0 cm without ultrasonographic evidence of nodal metastasis who underwent total thyroidectomy and prophylactic bilateral CLN dissection from July 2011eMay 2013. Patients were divided into three groups according to the total number of positive LNs in the combined prelaryngeal and pretracheal region.Results: Rates of metastasis to ipsilateral and contralateral central compartments in PTC > 1.0 cm were 84.3% and 24.2%, respectively. Multivariate analysis showed that >= 3 positive LNs in the combined prelaryngeal and pretracheal region were an independent predictive factor of contralateral CLN metastasis (P < 0.001; odds ratio, 8.585). After a mean follow-up of 24.1 mo, none of these patients had a recurrence in the central or lateral compartment.Conclusions: Occult metastasis is highly prevalent in the ipsilateral central neck of patients with PTC > 1.0 cm, and the total number of prelaryngeal and pretracheal LNs metastases may be a useful indicator to predict contralateral CLN metastasis in patients with unifocal PTC. (C) 2015 Elsevier Inc. All rights reserved.