Risk factors for persistent disease in papillary thyroid carcinoma with lymph node metastasis

Area of Science:

• Oncology
• Endocrinology
• Head and Neck Surgery

Background:

• Neck lymph node (LN) metastasis is a known correlate of persistent disease in papillary thyroid carcinoma (PTC).
• While many PTC patients achieve remission post-therapy, a subset experiences persistent disease.
• Identifying factors influencing disease course in PTC with LN metastasis is crucial for tailored management.

Purpose of the Study:

• To determine variables affecting the clinical course of PTC.
• To identify patterns of persistent disease in PTC patients with LN metastasis.
• To pinpoint risk factors for persistent disease in this patient cohort.

Main Methods:

• Analysis of clinicopathological characteristics and persistent disease patterns in PTC patients with LN metastasis.
• Univariate and multivariate analyses were employed to identify risk factors.
• Median follow-up duration was 84 months.

Main Results:

• 69% of patients achieved disease-free status; 31% had persistent disease.
• Univariate analysis identified male sex, age ≥45, tumor size >4 cm, lateral cervical LN metastasis, extrathyroidal invasion, and ≥10 metastatic LNs as predictors.
• Multivariate analysis revealed extrathyroidal involvement, lateral cervical LN metastasis, and age ≥45 as independent predictors.

Conclusions:

• Most PTC patients with LN involvement achieve disease-free status with therapy.
• Extrathyroidal invasion, lateral cervical LN involvement, and age ≥45 at diagnosis are associated with higher likelihood of persistent disease.
• Close clinical follow-up and appropriate therapy can lead to disease control.