Hostname: page-component-78c5997874-v9fdk Total loading time: 0 Render date: 2024-11-10T14:33:18.849Z Has data issue: false hasContentIssue false
  • English
  • Français

Analysis of the prognostic significance of lymph node related characteristics in papillary thyroid carcinoma patients presenting with pre- or intra-operative evidence of cervical lymph node metastases

Published online by Cambridge University Press:  17 March 2014

E Soudry ,
O Hilly ,
M Preis ,
T Hadar ,
K Segal ,
G Bachar  and
R Feinmesser
E Soudry
Affiliation:
Department of Otolaryngology-Head and Neck Surgery, Rabin Medical Center, Petah Tiqwa, Israel Sackler School of Medicine, Tel Aviv University, Israel
O Hilly
Affiliation:
Department of Otolaryngology-Head and Neck Surgery, Rabin Medical Center, Petah Tiqwa, Israel
M Preis
Affiliation:
Department of Otolaryngology-Head and Neck Surgery, Rabin Medical Center, Petah Tiqwa, Israel Sackler School of Medicine, Tel Aviv University, Israel
T Hadar
Affiliation:
Department of Otolaryngology-Head and Neck Surgery, Rabin Medical Center, Petah Tiqwa, Israel Sackler School of Medicine, Tel Aviv University, Israel
K Segal
Affiliation:
Department of Otolaryngology-Head and Neck Surgery, Rabin Medical Center, Petah Tiqwa, Israel Sackler School of Medicine, Tel Aviv University, Israel
G Bachar
Affiliation:
Department of Otolaryngology-Head and Neck Surgery, Rabin Medical Center, Petah Tiqwa, Israel Sackler School of Medicine, Tel Aviv University, Israel
R Feinmesser*
Affiliation:
Department of Otolaryngology-Head and Neck Surgery, Rabin Medical Center, Petah Tiqwa, Israel Sackler School of Medicine, Tel Aviv University, Israel
*
Address for correspondence: Dr R Feinmesser, Department of Otolaryngology-Head and Neck Surgery, Rabin Medical Center, Beilinson Campus, Petah Tiqwa 49100, Israel Fax: +972 3 937 6467 E-mail: Fein@clalit.org.il
Get access Rights & Permissions [Opens in a new window]

Abstract

Objective:

To identify the prognostic significance of specific lymph node related characteristics for disease persistence and recurrence in patients with pre- or intra-operative evidence of neck metastases and no other risk factors.

Method and results

Sixty-eight patients were identified; 50 per cent had persistent or recurrent disease. All underwent the same treatment strategy. There were no statistically significant differences in any of the patient- or tumour-related parameters when patients with and without persistence or recurrence were compared. Patients with recurrent or persistent disease had significantly larger (>3 cm) metastatic lymph nodes, but there were no differences regarding other lymph node related parameters (i.e. number, extracapsular extension, number of lymph nodes with extracapsular extension, and central vs lateral neck location). On multivariate analysis, however, none of the parameters were predictive of persistent or recurrent disease.

Conclusion:

In papillary thyroid carcinoma patients with no other risk factors, pre- or intra-operative evidence of cervical metastases was associated with a very high rate of disease persistence or recurrence. Specific lymph node characteristics were not shown to have prognostic significance.

Keywords

Thyroid NeoplasmsPapillary Thyroid CarcinomaNeoplasm MetastasesLymphadenopathyPrognosisPathology
Type
Main Articles
Information
The Journal of Laryngology & Otology , Volume 128 , Issue 3 , March 2014 , pp. 284 - 288
Copyright
Copyright © JLO (1984) Limited 2014 

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

1Tuttle, RM, Leboeuf, R, Martorella, AJ. Papillary thyroid cancer: monitoring and therapy. Endocrinol Metabol Clin North Am 2007;36:753–78CrossRefGoogle ScholarPubMed
2Mazzaferi, EL, Jhiang, SM. Long-term impact of initial surgical and medical therapy on papillary and follicular thyroid cancer. Am J Med 1994;97:418–28Google Scholar
3Tsang, RW, Brierley, JD, Simpson, WJ, Panzarella, T, Gospodarowicz, MK, Sutcliffe, SB. The effects of surgery, radioiodine, and external radiation therapy on the clinical outcome of patients with differentiated thyroid carcinoma. Cancer 1998;82:375–883.0.CO;2-V>CrossRefGoogle ScholarPubMed
4Yamashita, H, Noguchi, S, Murakami, N, Kawamoto, H, Watanabe, S. Extracapsular invasion of lymph node metastasis is an indicator of distant metastasis and poor prognosis in patients with thyroid papillary carcinoma. Cancer 1997;80:2268–723.0.CO;2-Q>CrossRefGoogle ScholarPubMed
5Lundgren, CI, Hall, P, Dickman, PW, Zedenius, J. Clinically significant prognostic factors for differentiated thyroid carcinoma. Cancer 2006;106:524–31Google Scholar
6Loh, HC, Greenspan, FS, Gee, L, Miller, TR, Yeo, PP. pTNM staging for papillary and follicular thyroid carcinomas: a retrospective analysis of 700 patients. J Clin Endocrinol Metabol 1997;82:3553–62Google Scholar
7Spires, JR, Robbins, T, Luna, MA, Byers, RM. Metastatic papillary carcinoma of the thyroid: the significance of extranodal extension. Head Neck 1989;11:242–6CrossRefGoogle ScholarPubMed
8Leboulleux, S, Rubino, C, Baudin, E, Caillou, B, Hartl, DM, Bidart, JM et al. Prognostic factors for persistent or recurrent disease of papillary thyroid carcinoma with neck lymph node metastases and/or tumor extension beyond the thyroid capsule at initial diagnosis. J Clin Endocrinol Metabol 2005;90:5723–9CrossRefGoogle ScholarPubMed
9Gilliland, FD, Hunt, WC, Morris, DM, Key, CR. Prognostic factors for thyroid carcinoma: a population based study of 15,698 cases from the Surveillance, Epidemiology, and End Results (SEER) program, 1973–1991. Cancer 1997;79:564–73Google Scholar
10Sherman, SI, Brierley, JD, Sperling, M, Ain, KB, Bigos, ST, Cooper, DS et al. Prospective multicenter study of treatment of thyroid carcinoma: initial analysis of staging and outcome. Cancer 1998;83:1012–21Google ScholarPubMed
11Mazzaferi, EL. Management of a solitary thyroid nodule. N Engl J Med 1993;328:553–9Google Scholar
12Dottorini, ME, Viganti, A, Mazzuccheli, L, Lomuscio, G, Colombo, L. Differentiated thyroid carcinoma in children and adolescents: a 37-year experience in 85 patients. J Nucl Med 1997;38:669–75Google Scholar
13Samuel, AM, Rajashekharrao, B, Shah, DH. Pulmonary metastases in children and adolescents with well-differentiated thyroid cancer. J Nucl Med 1998;39:1531–6Google Scholar
14LiVolsi, VA. Papillary lesions of the thyroid. In: LiVolsi, VA, ed. Surgical Pathology of the Thyroid. Philadelphia: WB Saunders, 1990;136–72Google Scholar
15Brennan, MD, Bergstralh, EJ, van Heerden, JA, McConahey, WM. Follicular thyroid cancer treated at the Mayo Clinic, 1946 through 1970: initial manifestations. Pathologic findings, therapy and outcome. Mayo Clinic Proc 1991;66:11–22CrossRefGoogle Scholar
16Moosa, M, Mazzaferri, EL. Occult thyroid carcinoma. Cancer J 1997;10:180–8Google Scholar
17Baudin, E, Travagli, JP, Ropers, J, Mancusi, F, Bruno-Bossio, G, Caillou, B et al. Microcarcinoma of the thyroid gland: the Goustav-Roussy Institute experience. Cancer 1998;83:553–9Google Scholar
18Hay, ID, Bergstralh, EJ, Goellner, JR, Ebersold, JR, Grant, CS. Predicting outcome in papillary thyroid carcinoma: development of a reliable prognostic scoring system in a cohort of 1779 patients surgically treated at one institution during 1940 through 1989. Surgery 1993;114:1050–8Google Scholar
19Mazzaferri, El. Papillary thyroid carcinoma: factors influencing prognosis and current therapy. Sem Oncol 1987;14:315–32Google ScholarPubMed
20LiVolsi, VA. Follicular lesions of the thyroid. In: LiVolsi, VA, ed. Surgical Pathology of the Thyroid. Philadelphia: WB Saunders, 1990;173–212Google Scholar
21Shaha, AR, Loree, TR, Shah, JP. Prognostic factors and risk group analysis in follicular carcinoma of the thyroid. Surgery 1995;118:1131–8Google Scholar
22Cady, B. Staging in thyroid carcinoma. Cancer 1998;83:844–7Google Scholar
23Lin, JD, Liou, MJ, Chao, TC, Weng, HF, Ho, YS. Prognostic variables of papillary and follicular thyroid carcinoma patients with lymph node metastases and without distant metastases. Endocr Relat Cancer 1999;6:109–15CrossRefGoogle ScholarPubMed
24Hughes, CJ, Shaha, AR, Shah, JP, Loree, TR. Impact of lymph node metastasis in differentiated carcinoma of the thyroid: a matched pair analysis. Head Neck 1996;18:127–323.0.CO;2-3>CrossRefGoogle ScholarPubMed
25Sugitani, I, Kasai, N, Fujimoto, Y, Yanagisawa, A. A novel classification system for patients with PTC: addition of the new variables of large (3 cm or greater) nodal metastases and reclassification during follow-up period. Surgery 2004;135:139–48Google Scholar
26Beasley, NJ, Lee, J, Eski, S, Walfish, P, Witterick, I, Freeman, JL. Impact of nodal metastases on prognosis in patients with well-differentiated thyroid cancer. Arch Otolaryngol Head Neck Surg 2002;128:825–8Google Scholar
27Mercante, G, Frasoldati, A, Pedroni, C, Formisano, D, Renna, L, Piana, S et al. Prognostic factors affecting neck lymph node recurrence and distant metastasis in papillary microcarcinoma of the thyroid: results in 445 patients. Thyroid 2009;19:707–16CrossRefGoogle ScholarPubMed
28Pellegriti, G, Scollo, C, Lumera, G, Regalbuto, C, Vigneri, R, Belfiore, A. Clinical behavior and outcome of papillary thyroid cancers smaller than 1.5 cm in diameter: study of 299 cases. J Clin Endocrinol Metab 2004;89:3713–20CrossRefGoogle ScholarPubMed
29Soyluk, O, Selcukbiricik, F, Ebril, Y, Bozbora, A, Kapran, Y, Ozbey, N. Prognostic factors in patients with papillary thyroid carcinoma. J Endocrinol Invest 2008;31:1032–7Google Scholar