The extent of lymph node yield in central neck dissection can be affected by preoperative and intraoperative assessment and alter the prognosis of papillary thyroid carcinoma
Abstract Background Lymph node yield (LNY) was implemented in the stratification of papillary thyroid cancer (PTC) patients. The effect of LNY may be related to the extent of surgery. This study aims to identify influencing factors for LNY in central compartment neck dissection (CND). Methods Data o...
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| Format: | Article |
| Language: | English |
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Wiley
2020-02-01
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| Series: | Cancer Medicine |
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| Online Access: | https://doi.org/10.1002/cam4.2762 |
| _version_ | 1797984971421384704 |
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| author | Jia‐Qian Hu Duo Wen Ben Ma Ting‐Ting Zhang Tian Liao Xiao Shi Yu‐Long Wang Yong‐Xue Zhu Yu Wang Wen‐Jun Wei Qing‐Hai Ji |
| author_facet | Jia‐Qian Hu Duo Wen Ben Ma Ting‐Ting Zhang Tian Liao Xiao Shi Yu‐Long Wang Yong‐Xue Zhu Yu Wang Wen‐Jun Wei Qing‐Hai Ji |
| author_sort | Jia‐Qian Hu |
| collection | DOAJ |
| description | Abstract Background Lymph node yield (LNY) was implemented in the stratification of papillary thyroid cancer (PTC) patients. The effect of LNY may be related to the extent of surgery. This study aims to identify influencing factors for LNY in central compartment neck dissection (CND). Methods Data of 13 712 consecutive PTC patients were analyzed retrospectively. Risk factors for LNY in CND and distribution characteristics of LNY were evaluated. Its relationship with prognosis was studied in another cohort of 136 cases. Results LNY in therapeutic CND was significantly higher than prophylactic CND (Unilateral: 5.55 ± 3.79 vs 3.41 ± 2.77; Bilateral: 8.90 ± 5.10 vs 6.47 ± 4.17, P < .001). Other independent factors included extranodal extension (ETE), tumor size, and concurrent Hashimoto's thyroiditis. The inconsistency distribution of LNY in bilateral CND was associated with preoperative and intraoperative assessment. Patients with significant difference between major and minor LNY suffered from poorer prognosis (10y‐RFS: 58.3% vs 92.0%; HR = 6.719, 95%, P < .0001). Conclusions CND surgical procedure, ETE, and Hashimoto's thyroiditis were independent factors of LNY. Inconsistent distribution of LNY was associated with prognosis of bilateral PTC patients. The impact of preoperative and intraoperative assessment on the actual extent of CND can be used to explain the relationship between LNY and PTC prognosis. |
| first_indexed | 2024-04-11T07:10:20Z |
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| id | doaj.art-8f80fb1ac1184f768d8990c0ae6997a3 |
| institution | Directory Open Access Journal |
| issn | 2045-7634 |
| language | English |
| last_indexed | 2024-04-11T07:10:20Z |
| publishDate | 2020-02-01 |
| publisher | Wiley |
| record_format | Article |
| series | Cancer Medicine |
| spelling | doaj.art-8f80fb1ac1184f768d8990c0ae6997a32022-12-22T04:38:14ZengWileyCancer Medicine2045-76342020-02-01931017102410.1002/cam4.2762The extent of lymph node yield in central neck dissection can be affected by preoperative and intraoperative assessment and alter the prognosis of papillary thyroid carcinomaJia‐Qian Hu0Duo Wen1Ben Ma2Ting‐Ting Zhang3Tian Liao4Xiao Shi5Yu‐Long Wang6Yong‐Xue Zhu7Yu Wang8Wen‐Jun Wei9Qing‐Hai Ji10Department of Head and Neck Surgery Fudan University Shanghai Cancer Center Shanghai ChinaDepartment of Head and Neck Surgery Fudan University Shanghai Cancer Center Shanghai ChinaDepartment of Head and Neck Surgery Fudan University Shanghai Cancer Center Shanghai ChinaDepartment of Head and Neck Surgery Fudan University Shanghai Cancer Center Shanghai ChinaDepartment of Head and Neck Surgery Fudan University Shanghai Cancer Center Shanghai ChinaDepartment of Head and Neck Surgery Fudan University Shanghai Cancer Center Shanghai ChinaDepartment of Head and Neck Surgery Fudan University Shanghai Cancer Center Shanghai ChinaDepartment of Head and Neck Surgery Fudan University Shanghai Cancer Center Shanghai ChinaDepartment of Head and Neck Surgery Fudan University Shanghai Cancer Center Shanghai ChinaDepartment of Head and Neck Surgery Fudan University Shanghai Cancer Center Shanghai ChinaDepartment of Head and Neck Surgery Fudan University Shanghai Cancer Center Shanghai ChinaAbstract Background Lymph node yield (LNY) was implemented in the stratification of papillary thyroid cancer (PTC) patients. The effect of LNY may be related to the extent of surgery. This study aims to identify influencing factors for LNY in central compartment neck dissection (CND). Methods Data of 13 712 consecutive PTC patients were analyzed retrospectively. Risk factors for LNY in CND and distribution characteristics of LNY were evaluated. Its relationship with prognosis was studied in another cohort of 136 cases. Results LNY in therapeutic CND was significantly higher than prophylactic CND (Unilateral: 5.55 ± 3.79 vs 3.41 ± 2.77; Bilateral: 8.90 ± 5.10 vs 6.47 ± 4.17, P < .001). Other independent factors included extranodal extension (ETE), tumor size, and concurrent Hashimoto's thyroiditis. The inconsistency distribution of LNY in bilateral CND was associated with preoperative and intraoperative assessment. Patients with significant difference between major and minor LNY suffered from poorer prognosis (10y‐RFS: 58.3% vs 92.0%; HR = 6.719, 95%, P < .0001). Conclusions CND surgical procedure, ETE, and Hashimoto's thyroiditis were independent factors of LNY. Inconsistent distribution of LNY was associated with prognosis of bilateral PTC patients. The impact of preoperative and intraoperative assessment on the actual extent of CND can be used to explain the relationship between LNY and PTC prognosis.https://doi.org/10.1002/cam4.2762central neck dissectionlymph node yieldpapillary thyroid cancersurgical assessment |
| spellingShingle | Jia‐Qian Hu Duo Wen Ben Ma Ting‐Ting Zhang Tian Liao Xiao Shi Yu‐Long Wang Yong‐Xue Zhu Yu Wang Wen‐Jun Wei Qing‐Hai Ji The extent of lymph node yield in central neck dissection can be affected by preoperative and intraoperative assessment and alter the prognosis of papillary thyroid carcinoma Cancer Medicine central neck dissection lymph node yield papillary thyroid cancer surgical assessment |
| title | The extent of lymph node yield in central neck dissection can be affected by preoperative and intraoperative assessment and alter the prognosis of papillary thyroid carcinoma |
| title_full | The extent of lymph node yield in central neck dissection can be affected by preoperative and intraoperative assessment and alter the prognosis of papillary thyroid carcinoma |
| title_fullStr | The extent of lymph node yield in central neck dissection can be affected by preoperative and intraoperative assessment and alter the prognosis of papillary thyroid carcinoma |
| title_full_unstemmed | The extent of lymph node yield in central neck dissection can be affected by preoperative and intraoperative assessment and alter the prognosis of papillary thyroid carcinoma |
| title_short | The extent of lymph node yield in central neck dissection can be affected by preoperative and intraoperative assessment and alter the prognosis of papillary thyroid carcinoma |
| title_sort | extent of lymph node yield in central neck dissection can be affected by preoperative and intraoperative assessment and alter the prognosis of papillary thyroid carcinoma |
| topic | central neck dissection lymph node yield papillary thyroid cancer surgical assessment |
| url | https://doi.org/10.1002/cam4.2762 |
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