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Clinicopathologic risk factors for right paraesophageal lymph node metastasis in patients with papillary thyroid carcinoma

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Abstract

Objectives

To investigate risk factors associated with right paraesophageal lymph node (RPELN) metastasis in patients with papillary thyroid carcinoma (PTC) and to determine the indications for right lymph node dissection.

Methods

Clinicopathologic data from 829 patients (104 men and 725 women) with PTC, operated on by the same thyroid surgery team at the First Affiliated Hospital of Harbin Medical University from January 2013 to May 2017, were analyzed. Overall, 309 patients underwent total thyroidectomy with bilateral lymph node dissection, 488 underwent right thyroid lobe and isthmic resection with right central compartment lymph node dissection, and 32 underwent near-total thyroidectomy (ipsilateral thyroid lobectomy with contralateral near-total lobectomy) with bilateral lymph node dissection.

Results

The overall rate of central compartment lymph node metastasis was 43.5% (361/829), with right central compartment lymph node and RPELN metastasis rates of 35.5% (294/829) and 19.1% (158/829), respectively. Tumor size, number, invasion, and location, lymph node metastasis, right central compartment lymph node metastasis, and right lateral compartment lymph node metastasis were associated with RPELN in the univariate analysis, whereas age and sex were not. Multivariate analysis identified tumors with a diameter ≥ 1 cm, multiple tumors, tumors located in the right lobe, right central compartment lymph node metastasis, and right lateral compartment lymph node metastasis as independent risk factors for RPELN metastasis.

Conclusions

Lymph node dissection, including RPELN dissection, should be performed for patients with PTC with a tumor diameter ≥ 1 cm, multiple tumors, right-lobe tumors, right central compartment lymph node metastasis, or suspected lateral compartment lymph node metastasis.

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Abbreviations

OR:

Odds ratio

CI:

Confidence interval

PTC:

Papillary thyroid carcinoma

RPELN:

Right paraesophageal lymph node

rCLN:

Right central compartment lymph node

LLN:

Lateral compartment lymph node

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Authors and Affiliations

  1. Department of Thyroid Surgery, The First Affiliated Hospital Harbin Medical University, Harbin, 150001, Heilongjiang, China

    Q. A. Yu, D. K. Ma, K. P. Liu, C. M. Xie, Y. H. Wu & W. J. Dai

  2. Department of Liver Surgery, The First Affiliated Hospital Harbin Medical University, Harbin, 150001, Heilongjiang, China

    Q. A. Yu & H. C. Jiang

  3. Operating Room, The First Affiliated Hospital Harbin Medical University, Harbin, 150001, China

    P. Wang

Authors
  1. Q. A. Yu
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  2. D. K. Ma
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  3. K. P. Liu
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  4. P. Wang
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  5. C. M. Xie
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  6. Y. H. Wu
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  7. W. J. Dai
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  8. H. C. Jiang
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Corresponding authors

Correspondence to W. J. Dai or H. C. Jiang.

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Conflict of interest

The authors declare that they have no conflict of interests or financial interest invested in this work.

Ethical approval

This study was approved by the ethics committee of First Ailiated Hospital of Harbin Medical University. All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.

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Yu, Q.A., Ma, D.K., Liu, K.P. et al. Clinicopathologic risk factors for right paraesophageal lymph node metastasis in patients with papillary thyroid carcinoma. J Endocrinol Invest 41, 1333–1338 (2018). https://doi.org/10.1007/s40618-018-0874-4

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  • DOI: https://doi.org/10.1007/s40618-018-0874-4

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