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Predictors of Central Compartment Involvement in Patients with Positive Lateral Cervical Lymph Nodes According to Clinical and/or Ultrasound Evaluation

Lymph node neck metastases are frequent in papillary thyroid carcinoma (PTC). Current guidelines state, on a weak level of evidence, that level VI dissection is mandatory in the presence of latero-cervical metastases. The aim of our study is to evaluate predictive factors for the absence of level VI...

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Autores principales: Graceffa, Giuseppa, Orlando, Giuseppina, Cocorullo, Gianfranco, Mazzola, Sergio, Vitale, Irene, Proclamà, Maria Pia, Amato, Calogera, Saputo, Federica, Rollo, Enza Maria, Corigliano, Alessandro, Melfa, Giuseppina, Cipolla, Calogero, Scerrino, Gregorio
Formato: Online Artículo Texto
Lenguaje:English
Publicado: MDPI 2021
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8347254/
https://www.ncbi.nlm.nih.gov/pubmed/34362189
http://dx.doi.org/10.3390/jcm10153407
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author Graceffa, Giuseppa
Orlando, Giuseppina
Cocorullo, Gianfranco
Mazzola, Sergio
Vitale, Irene
Proclamà, Maria Pia
Amato, Calogera
Saputo, Federica
Rollo, Enza Maria
Corigliano, Alessandro
Melfa, Giuseppina
Cipolla, Calogero
Scerrino, Gregorio
author_facet Graceffa, Giuseppa
Orlando, Giuseppina
Cocorullo, Gianfranco
Mazzola, Sergio
Vitale, Irene
Proclamà, Maria Pia
Amato, Calogera
Saputo, Federica
Rollo, Enza Maria
Corigliano, Alessandro
Melfa, Giuseppina
Cipolla, Calogero
Scerrino, Gregorio
author_sort Graceffa, Giuseppa
collection PubMed
description Lymph node neck metastases are frequent in papillary thyroid carcinoma (PTC). Current guidelines state, on a weak level of evidence, that level VI dissection is mandatory in the presence of latero-cervical metastases. The aim of our study is to evaluate predictive factors for the absence of level VI involvement despite the presence of metastases to the lateral cervical stations in PTC. Eighty-eight patients operated for PTC with level II–V metastases were retrospectively enrolled in the study. Demographics, thyroid function, autoimmunity, nodule size and site, cancer variant, multifocality, Bethesda and EU-TIRADS, number of central and lateral lymph nodes removed, number of positive lymph nodes and outcome were recorded. At univariate analysis, PTC location and number of positive lateral lymph nodes were risk criteria for failure to cure. ROC curves demonstrated the association of the number of positive lateral lymph nodes and failure to cure. On multivariate analysis, the protective factors were PTC located in lobe center and number of positive lateral lymph nodes < 4. Kaplan–Meier curves confirmed the absence of central lymph nodes as a positive prognostic factor. In the selected cases, Central Neck Dissection (CND) could be avoided even in the presence of positive Lateralcervical Lymph Nodes (LLN+).
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spelling pubmed-83472542021-08-08 Predictors of Central Compartment Involvement in Patients with Positive Lateral Cervical Lymph Nodes According to Clinical and/or Ultrasound Evaluation Graceffa, Giuseppa Orlando, Giuseppina Cocorullo, Gianfranco Mazzola, Sergio Vitale, Irene Proclamà, Maria Pia Amato, Calogera Saputo, Federica Rollo, Enza Maria Corigliano, Alessandro Melfa, Giuseppina Cipolla, Calogero Scerrino, Gregorio J Clin Med Article Lymph node neck metastases are frequent in papillary thyroid carcinoma (PTC). Current guidelines state, on a weak level of evidence, that level VI dissection is mandatory in the presence of latero-cervical metastases. The aim of our study is to evaluate predictive factors for the absence of level VI involvement despite the presence of metastases to the lateral cervical stations in PTC. Eighty-eight patients operated for PTC with level II–V metastases were retrospectively enrolled in the study. Demographics, thyroid function, autoimmunity, nodule size and site, cancer variant, multifocality, Bethesda and EU-TIRADS, number of central and lateral lymph nodes removed, number of positive lymph nodes and outcome were recorded. At univariate analysis, PTC location and number of positive lateral lymph nodes were risk criteria for failure to cure. ROC curves demonstrated the association of the number of positive lateral lymph nodes and failure to cure. On multivariate analysis, the protective factors were PTC located in lobe center and number of positive lateral lymph nodes < 4. Kaplan–Meier curves confirmed the absence of central lymph nodes as a positive prognostic factor. In the selected cases, Central Neck Dissection (CND) could be avoided even in the presence of positive Lateralcervical Lymph Nodes (LLN+). MDPI 2021-07-30 /pmc/articles/PMC8347254/ /pubmed/34362189 http://dx.doi.org/10.3390/jcm10153407 Text en © 2021 by the authors. https://creativecommons.org/licenses/by/4.0/Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (https://creativecommons.org/licenses/by/4.0/).
spellingShingle Article
Graceffa, Giuseppa
Orlando, Giuseppina
Cocorullo, Gianfranco
Mazzola, Sergio
Vitale, Irene
Proclamà, Maria Pia
Amato, Calogera
Saputo, Federica
Rollo, Enza Maria
Corigliano, Alessandro
Melfa, Giuseppina
Cipolla, Calogero
Scerrino, Gregorio
Predictors of Central Compartment Involvement in Patients with Positive Lateral Cervical Lymph Nodes According to Clinical and/or Ultrasound Evaluation
title Predictors of Central Compartment Involvement in Patients with Positive Lateral Cervical Lymph Nodes According to Clinical and/or Ultrasound Evaluation
title_full Predictors of Central Compartment Involvement in Patients with Positive Lateral Cervical Lymph Nodes According to Clinical and/or Ultrasound Evaluation
title_fullStr Predictors of Central Compartment Involvement in Patients with Positive Lateral Cervical Lymph Nodes According to Clinical and/or Ultrasound Evaluation
title_full_unstemmed Predictors of Central Compartment Involvement in Patients with Positive Lateral Cervical Lymph Nodes According to Clinical and/or Ultrasound Evaluation
title_short Predictors of Central Compartment Involvement in Patients with Positive Lateral Cervical Lymph Nodes According to Clinical and/or Ultrasound Evaluation
title_sort predictors of central compartment involvement in patients with positive lateral cervical lymph nodes according to clinical and/or ultrasound evaluation
topic Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8347254/
https://www.ncbi.nlm.nih.gov/pubmed/34362189
http://dx.doi.org/10.3390/jcm10153407
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