Clinical Features in Differentiated Thyroid Carcinoma Stratified By Lymph Node Status

Area of Science:

• Oncology
• Endocrinology
• Surgical Pathology

Background:

• Cervical lymph node (CLN) metastases are common in differentiated thyroid cancer (DTC) and predict local recurrence.
• Lymph node status is a critical factor in DTC staging and management.
• Understanding the clinical implications of lymph node involvement is essential for patient outcomes.

Purpose of the Study:

• To evaluate clinical endpoints in differentiated thyroid cancer (DTC) patients based on cervical lymph node (CLN) metastasis status (N1, N0, Nx).
• To correlate lymph node involvement with key clinical and pathological features of DTC.
• To identify predictors of CLN metastasis in DTC.

Main Methods:

• Retrospective review of 261 DTC patients who underwent thyroidectomy (2006-2018).
• Classification of lymph node status according to AJCC 8th edition criteria (N1, N0, Nx).
• Statistical analysis including one-way ANOVA and pairwise comparisons to assess group differences.

Main Results:

• Significant differences observed in tumor multicentricity, tumor size, AJCC stage, and thyroglobulin auto-antibody (TgAb) levels among N1, N0, and Nx groups.
• N1 patients exhibited higher rates of multicentricity, larger tumors, and elevated TgAbs.
• No significant differences were found between the N0 (negative lymph nodes) and Nx (unresected lymph nodes) groups.

Conclusions:

• Larger and multicentric tumors are associated with a higher likelihood of CLN metastases in DTC.
• Elevated TgAbs may indicate a higher risk of CLN involvement.
• Recommendations include increased surveillance for CLN metastases in DTC patients with tumors >2 cm, multicentric tumors, or elevated TgAbs.