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Transoral Robotic Total Thyroidectomy and Bilateral Central Regional Lymph Node Dissection for Papillary Thyroid Carcinoma
Published on: September 15, 2023
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Lymph node location is a risk factor for papillary thyroid cancer-related death
G Sapuppo1, M Tavarelli1, M Russo2
1Endocrinology, Department of Clinical and Experimental Medicine, University of Catania, Garibaldi-Nesima Medical Center, Catania, Italy.
Journal of Endocrinological Investigation
|March 18, 2018
Summary
Metastatic lymph node location impacts papillary thyroid cancer (PTC) mortality risk. Specifically, N1b lymph node metastases are linked to increased cancer-specific death, highlighting their importance in post-surgery evaluations for PTC patients.
Area of Science:
- Oncology
- Endocrinology
- Surgical Pathology
Background:
- Papillary thyroid cancer (PTC) generally has a favorable prognosis.
- The prognostic significance of metastatic lymph node location in PTC has been debated.
- Recent TNM staging (VIII ed.) suggested no impact on prognosis for older patients.
Purpose of the Study:
- To investigate the specific role of metastasized lymph node location in predicting papillary thyroid cancer-related mortality.
- To clarify the prognostic value of lymph node involvement in PTC.
Main Methods:
- Retrospective analysis of 1653 consecutive PTC patients.
- Data collected from a dedicated Thyroid Clinic with a mean follow-up of 5.9 years.
- Evaluation of PTC-related mortality based on lymph node metastasis status (N0, N1a, N1b).
Main Results:
- Only 0.96% (16 out of 1653) of patients died due to PTC.
- The mortality rate significantly increased with lymph node metastasis.
- Death rates were 0.2% for N0, 0.3% for N1a, and notably 3.0% for N1b lymph node involvement.
Conclusions:
- Lymph node metastases in the N1b compartment represent a significant risk factor for PTC.
- N1b involvement is associated with an increased risk of distant spread and cancer-specific mortality.
- This finding should be incorporated into the post-surgical risk assessment for PTC patients.
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