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Predicting large-volume lymph node metastasis in the clinically node-negative papillary thyroid microcarcinoma: a

Guohua Shen1, Huan Ma2, Rui Huang1

  • 1Department of Nuclear Medicine, Laboratory of Clinical Nuclear Medicine, West China Hospital, Sichuan University.

Nuclear Medicine Communications
|November 26, 2019
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Summary

Young male patients with papillary thyroid microcarcinoma (PTMC) are more likely to have large-volume lymph node metastasis (LNM), a predictor of recurrence. This finding helps identify high-risk PTMC patients early.

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Area of Science:

  • Endocrinology
  • Oncology
  • Surgical Pathology

Background:

  • Large-volume lymph node metastasis (LNM) is a significant predictor of recurrence in papillary thyroid microcarcinoma (PTMC).
  • Clinical predictors for identifying large-volume LNM in PTMC remain underexplored.

Purpose of the Study:

  • To identify clinical predictors associated with large-volume LNM in clinically node-negative PTMC patients.
  • To understand the relationship between patient demographics, clinical factors, and LNM volume.

Main Methods:

  • Retrospective analysis of 947 clinically node-negative PTMC patients undergoing total thyroidectomy, lymph node dissection, and radioiodine therapy.
  • Patients were categorized into large-volume LNM and small-volume LNM (including no LNM) groups.
  • Statistical analysis investigated associations between age, gender, extrathyroid extension, and large-volume LNM, alongside recurrence-free survival.

Main Results:

  • Male gender (OR=1.865), young age (<40 years; OR=2.743), and extrathyroid extension (OR=5.352) were independent predictors of large-volume LNM.
  • Young males (<40 years) exhibited the highest prevalence of large-volume LNM (17.20%).
  • Large-volume LNM was associated with a significantly higher recurrence rate (15.48%) and decreased recurrence-free survival compared to small-volume LNM (0.72%).

Conclusions:

  • Young male patients with clinically node-negative PTMC have a higher incidence of large-volume LNM.
  • Identifying these predictors can aid in risk stratification and management of PTMC.
  • Large-volume LNM is a critical factor influencing recurrence risk in PTMC.