Predictors of Central Compartment Involvement in Patients with Positive Lateral Cervical Lymph Nodes According to Clinical and/or Ultrasound Evaluation
Lymph node neck metastases are frequent in papillary thyroid carcinoma (PTC). Current guidelines state, on a weak level of evidence, that level VI dissection is mandatory in the presence of latero-cervical metastases. The aim of our study is to evaluate predictive factors for the absence of level VI...
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MDPI AG
2021-07-01
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| Series: | Journal of Clinical Medicine |
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| Online Access: | https://www.mdpi.com/2077-0383/10/15/3407 |
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| author | Giuseppa Graceffa Giuseppina Orlando Gianfranco Cocorullo Sergio Mazzola Irene Vitale Maria Pia Proclamà Calogera Amato Federica Saputo Enza Maria Rollo Alessandro Corigliano Giuseppina Melfa Calogero Cipolla Gregorio Scerrino |
| author_facet | Giuseppa Graceffa Giuseppina Orlando Gianfranco Cocorullo Sergio Mazzola Irene Vitale Maria Pia Proclamà Calogera Amato Federica Saputo Enza Maria Rollo Alessandro Corigliano Giuseppina Melfa Calogero Cipolla Gregorio Scerrino |
| author_sort | Giuseppa Graceffa |
| collection | DOAJ |
| description | Lymph node neck metastases are frequent in papillary thyroid carcinoma (PTC). Current guidelines state, on a weak level of evidence, that level VI dissection is mandatory in the presence of latero-cervical metastases. The aim of our study is to evaluate predictive factors for the absence of level VI involvement despite the presence of metastases to the lateral cervical stations in PTC. Eighty-eight patients operated for PTC with level II–V metastases were retrospectively enrolled in the study. Demographics, thyroid function, autoimmunity, nodule size and site, cancer variant, multifocality, Bethesda and EU-TIRADS, number of central and lateral lymph nodes removed, number of positive lymph nodes and outcome were recorded. At univariate analysis, PTC location and number of positive lateral lymph nodes were risk criteria for failure to cure. ROC curves demonstrated the association of the number of positive lateral lymph nodes and failure to cure. On multivariate analysis, the protective factors were PTC located in lobe center and number of positive lateral lymph nodes < 4. Kaplan–Meier curves confirmed the absence of central lymph nodes as a positive prognostic factor. In the selected cases, Central Neck Dissection (CND) could be avoided even in the presence of positive Lateralcervical Lymph Nodes (LLN+). |
| first_indexed | 2024-03-10T09:13:11Z |
| format | Article |
| id | doaj.art-a23672184590434fbed29e7685ca0bcc |
| institution | Directory Open Access Journal |
| issn | 2077-0383 |
| language | English |
| last_indexed | 2024-03-10T09:13:11Z |
| publishDate | 2021-07-01 |
| publisher | MDPI AG |
| record_format | Article |
| series | Journal of Clinical Medicine |
| spelling | doaj.art-a23672184590434fbed29e7685ca0bcc2023-11-22T05:50:21ZengMDPI AGJournal of Clinical Medicine2077-03832021-07-011015340710.3390/jcm10153407Predictors of Central Compartment Involvement in Patients with Positive Lateral Cervical Lymph Nodes According to Clinical and/or Ultrasound EvaluationGiuseppa Graceffa0Giuseppina Orlando1Gianfranco Cocorullo2Sergio Mazzola3Irene Vitale4Maria Pia Proclamà5Calogera Amato6Federica Saputo7Enza Maria Rollo8Alessandro Corigliano9Giuseppina Melfa10Calogero Cipolla11Gregorio Scerrino12Unit of Oncological Surgery, Department of Surgical Oncological and Oral Sciences, University of Palermo, Via del Vespro, 129, 90127 Palermo, ItalyUnit of General and Emergency Surgery, Department of Surgical Oncological and Oral Sciences, Policlinico P. Giaccone, University of Palermo, Via L Giuffré, 5, 90127 Palermo, ItalyUnit of General and Emergency Surgery, Department of Surgical Oncological and Oral Sciences, Policlinico P. Giaccone, University of Palermo, Via L Giuffré, 5, 90127 Palermo, ItalyUnit of Clinical Epidemiology & Tumor Registry, Department of Laboratory Diagnostics, Policlinico P. Giaccone, University of Palermo, Via L Giuffré, 5, 90127 Palermo, ItalyUnit of General and Emergency Surgery, Department of Surgical Oncological and Oral Sciences, Policlinico P. Giaccone, University of Palermo, Via L Giuffré, 5, 90127 Palermo, ItalyUnit of General and Emergency Surgery, Department of Surgical Oncological and Oral Sciences, Policlinico P. Giaccone, University of Palermo, Via L Giuffré, 5, 90127 Palermo, ItalyUnit of General and Emergency Surgery, Department of Surgical Oncological and Oral Sciences, Policlinico P. Giaccone, University of Palermo, Via L Giuffré, 5, 90127 Palermo, ItalyUnit of Oncological Surgery, Department of Surgical Oncological and Oral Sciences, University of Palermo, Via del Vespro, 129, 90127 Palermo, ItalyUnit of Oncological Surgery, Department of Surgical Oncological and Oral Sciences, University of Palermo, Via del Vespro, 129, 90127 Palermo, ItalyUnit of Endocrine Surgery, Department of Surgical Oncological and Oral Sciences, Policlinico P. Giaccone, University of Palermo, Via L Giuffré, 5, 90127 Palermo, ItalyUnit of General and Emergency Surgery, Department of Surgical Oncological and Oral Sciences, Policlinico P. Giaccone, University of Palermo, Via L Giuffré, 5, 90127 Palermo, ItalyUnit of Oncological Surgery, Department of Surgical Oncological and Oral Sciences, University of Palermo, Via del Vespro, 129, 90127 Palermo, ItalyUnit of Endocrine Surgery, Department of Surgical Oncological and Oral Sciences, Policlinico P. Giaccone, University of Palermo, Via L Giuffré, 5, 90127 Palermo, ItalyLymph node neck metastases are frequent in papillary thyroid carcinoma (PTC). Current guidelines state, on a weak level of evidence, that level VI dissection is mandatory in the presence of latero-cervical metastases. The aim of our study is to evaluate predictive factors for the absence of level VI involvement despite the presence of metastases to the lateral cervical stations in PTC. Eighty-eight patients operated for PTC with level II–V metastases were retrospectively enrolled in the study. Demographics, thyroid function, autoimmunity, nodule size and site, cancer variant, multifocality, Bethesda and EU-TIRADS, number of central and lateral lymph nodes removed, number of positive lymph nodes and outcome were recorded. At univariate analysis, PTC location and number of positive lateral lymph nodes were risk criteria for failure to cure. ROC curves demonstrated the association of the number of positive lateral lymph nodes and failure to cure. On multivariate analysis, the protective factors were PTC located in lobe center and number of positive lateral lymph nodes < 4. Kaplan–Meier curves confirmed the absence of central lymph nodes as a positive prognostic factor. In the selected cases, Central Neck Dissection (CND) could be avoided even in the presence of positive Lateralcervical Lymph Nodes (LLN+).https://www.mdpi.com/2077-0383/10/15/3407papillary thyroid carcinomacentral compartmentlateralcervical lymph nodesEU-TIRADSBethesdacentral neck dissection |
| spellingShingle | Giuseppa Graceffa Giuseppina Orlando Gianfranco Cocorullo Sergio Mazzola Irene Vitale Maria Pia Proclamà Calogera Amato Federica Saputo Enza Maria Rollo Alessandro Corigliano Giuseppina Melfa Calogero Cipolla Gregorio Scerrino Predictors of Central Compartment Involvement in Patients with Positive Lateral Cervical Lymph Nodes According to Clinical and/or Ultrasound Evaluation Journal of Clinical Medicine papillary thyroid carcinoma central compartment lateralcervical lymph nodes EU-TIRADS Bethesda central neck dissection |
| title | Predictors of Central Compartment Involvement in Patients with Positive Lateral Cervical Lymph Nodes According to Clinical and/or Ultrasound Evaluation |
| title_full | Predictors of Central Compartment Involvement in Patients with Positive Lateral Cervical Lymph Nodes According to Clinical and/or Ultrasound Evaluation |
| title_fullStr | Predictors of Central Compartment Involvement in Patients with Positive Lateral Cervical Lymph Nodes According to Clinical and/or Ultrasound Evaluation |
| title_full_unstemmed | Predictors of Central Compartment Involvement in Patients with Positive Lateral Cervical Lymph Nodes According to Clinical and/or Ultrasound Evaluation |
| title_short | Predictors of Central Compartment Involvement in Patients with Positive Lateral Cervical Lymph Nodes According to Clinical and/or Ultrasound Evaluation |
| title_sort | predictors of central compartment involvement in patients with positive lateral cervical lymph nodes according to clinical and or ultrasound evaluation |
| topic | papillary thyroid carcinoma central compartment lateralcervical lymph nodes EU-TIRADS Bethesda central neck dissection |
| url | https://www.mdpi.com/2077-0383/10/15/3407 |
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