Frequency of nodal metastasis in differentiated thyroid carcinoma
DOI:
https://doi.org/10.18203/2320-6012.ijrms20231020Keywords:
Nodal metastasis, Carcinoma, Thyroid gland, Papillary, FollicularAbstract
Background: Thyroid cancer is the most common endocrine malignancy. Moreover, within thyroid cancer, differentiated thyroid carcinoma (DTC) is the most common variety, with the incidence rising over the past decade. Often, most of the cases present with multicentric disease and presenting with lymph node metastases at the time of diagnosis. Nodal metastasis has prognostic importance, and it may guide surgeons regarding further management. Considering this scientific fact, the study was performed to see the frequency of lymph node metastasis in DTC among the patients admitted to a tertiary care hospital.
Methods: This cross-sectional study was conducted in the department of otolaryngology and head-neck surgery, Sher-E-Bangla Medical College Hospital, for 9 months after the acceptance of the protocol. A total of 50 patients (in all age groups) who attended the relevant department due to thyroid malignancies were approached and interviewed. Thorough history taking, physical examination, and relevant investigation were done and recorded into separate case record forms. Informed written consent was taken from each subject. Following collection, data were coded and inputted into statistical software. Data analysis was done with SPSS 21 according to the objective of the study. Data were presented in the form of tables, and charts.
Results: Among the 50 patients, the mean age of the patients was 47.86±15.69 SD (years) with minimum and maximum ages of 14 and 78 years respectively. The male-female ratio was 1:4 (20% male vs 80% female). Papillary carcinoma was the most frequent (88%) followed by follicular (10%). Nodal metastasis was most common in the papillary variety, about 54.55% of cases, whereas 20% were present in the follicular variety. The majority of the patients underwent total thyroidectomy with neck dissection (90%) and the remaining cases were managed by lobectomy (10%).
Conclusions: This study concluded that nodal metastasis was present in 54.55% of cases of papillary carcinoma.
Metrics
References
Flint PW, Haughy BH, Robbins KT, Thomas JR, Niparko JK, Lund VJ, et al. Cummings Otolaryngolongy-Head and Neck Surgery E-Book. Elsevier Heal Sci. 2014;28.
Gleeson M, Browning G, Burton Martin J. Scott-Brown’s Otolaryngology, Head and Neck Surgery, 7th edition. Hodder Arnold (publishers) Ltd. 2008;2:2292-304.
William NS, Bulstrode CJK, O’Connel PR. The Thyroid and parathyroid glands. Bailey and Love’s Short practice of surgery, 25th edition; Hodder Arnold, London. 2008;771-806.
Kendall L, Condon R. Prediction of malignancy in solitary thyroid nodules. The lancet. 1969;293(7605):1071-3.
Psarras A, Papadopoulos SN, Livadas D, Pharmakiotis AD, Koultras DA. The singly thyroid nodule. Bri J Surg.1972;59(7):545-8.
Watkinson JC, Gaze MN, Wilson JA. Tumors of the thyroid and parathyroid glands, Stell and Maran’s Head Neck Surgery, 5th edn, Butterworth Heinemann. 2000;459-63.
Wada N, Duh Q, Surgino K, Iwaski H, Kameyama K, Mimura T, et al. Lymph node metastasis from 259 papillary thyroid microcarcinomas: Frequency pattern of occurrence and recurrence and optimal strategy for neck dissection. Ann Surg. 2003;237:399-407.
Lin X, Zhu B, Liu y, Silverman JF. Follicular thyroid carcinoma invades venous rather than lymphatic vessel, Diagnostic Pathol. 2010;5(1):8.
Roh JL, Park YJ, Park CI. Total Thyroidectomy plus neck dissection in differentiated papillay thyroid carcinoma patient: Pattern of nodal metastasis, morbidity, recurrence and postoperative levels of serum parathyroid hormone. Ann Surg. 2007;245(4):604-10.
Ito Y, Jikuzono T, Higashiyama T, Asahi S, Tomoda C, Takamura Y,, et al. Clinical significance of lymph node metastasis of thyroid papillary carcinoma located in one lobe. World J Surg. 2006;30(10):1821-8.
Saha AR, Shah JP, Loree TR. Pattern of nodal and distant metastasis based on histologic varieties in differentiated carcinoma of thyroid. Am J Surg. 1996;172(6):692-4.
Wengen DF, Donald PJ. Compilations of radical neck dissection. The Neck: Diagnosis Surg.1994:483-509.
Goropoulos A, Karamoshos K, Christodoulou A, Ntitias T, Paulou K, Samaras A, et al. Value of the cervical compartments in the surgical treatment of papillary thyroid carcinoma. World J Surg. 2004;28(12):1275-81.
Kupferman ME, Patterson M, Mandel SJ, LiVolsi V, Weber RS. Patterns of lateral neck metastasis in papillary thyroid carcinoma. Arch Otolaryngol Head Neck Surg. 2004;130 (7):857-60.
Cabanillas ME, McFadden DG, Durante C. Thyroid cancer. Lancet. 2016;388(10061):2783-95.
Tuttle RM, Ball DW, Byrd D, Dilawari RA, Doherty GM, Duh QY, et al. Thyroid carcinoma. J National Comprehensive Cancer Network. 2010;8:1228-74.
Howlader N, Noone AM, Krapcho M. SEER Cancer Statistics Review, 1975-2013. Bethesda: National Cancer Institute. 2016.
Mizrachi A, Shaha AR. Lymph Node Dissection for Differentiated Thyroid Cancer. Molecular Imaging Radionucl Therapy. 2017;26(1):10-5.
Sampson E, Brierley JD, Le LW, Rotstein L, Tsang RW. Clinical management and outcome of papillary and follicular (differentiated) thyroid cancer presenting with distant metastasis at diagnosis. Cancer 2007;110(7):1451-6.
Ito Y, Miyauchi A, Kihara M, Higashiyama T, Kobayashi K, Miya A. Prognostic significance of young age in papillary thyroid carcinoma: analysis of 5,733 patients with 150 months’ median followup. Endocrinol J. 2014;61(5):491-7.
Ito Y, Miyauchi A, Tomoda C, Hirokawa M, Kobayashi K, Miya A. Prognostic significance of patient age in minimally and widely invasive follicular thyroid carcinoma: investigation of three age groups. Endocrinol J. 2014;61(3):265-71.
Sippel RS, Chen H. Controversies in the surgical management of newly diagnosed and recurrent/residual thyroid cancer. Thyroid. 2009;19(12):1373-80.
McHenry CR, Phitayakorn R. Difficult problems in thyroid cancer surgery. Minerva Chirurgica. 2010;65(1):83-93.
Sadowski BM, Snyde SK, Lairmore TC. Routine bilateral central lymph node clearance for papillary thyroid cancer. Surgery. 2009;146(4):696-705.
Giles Y, Tunca F, Boztepe H, Alag¨ol F, Terzioglu T, Tezelman S. The long term outcome of papillary thyroid carcinoma patients without primary central lymph node dissection: expected improvement of routine dissection. Surgery. 2009;146(6):1188-95.
Do BA, Payne RJ, Bastianelli M, Mlynarek AM, Tamilia M, Hier M, et al. Is age associated with risk of malignancy in thyroid cancer? Otolaryngol Head Neck Surgery. 2014;151(5):746-50.
Girardi FM. Thyroid Carcinoma Pattern Presentation According to Age. Int Arch Otorhinolaryngol. 2017;21(1):38-41.
Wang TS, Dubner S, Sznyter LA, Heller KS. Incidence of metastatic well-differentiated thyroid cancer in cervical lymph nodes. Arch Otolaryngol Head Neck Surg. 2004;130:110-3.
Kwong N, Medici M, Angell TE, Liu X, Marqusee E, Cibas ES, et al. The influence of patient age on thyroid nodule formation, multinodularity, and thyroid cancer risk. J Clin Endocrinol Metabol. 2015;100(12):4434-40.
Han SH, Lee MS, Kim HJ, Kim YD, Kim HY. Patterns of cervical lymph node metastasis in differentiated thyroid carcinoma. J Kor Cancer Asso. 1996;28(4):665-70.
Stansifer KJ, Guynan JF, Wachal BM, Smith RB. Modifiable Risk Factors and Thyroid Cancer. Otolaryngol Neck Surg. 2015;152(3):432-7.
Kim J, Sun Z, Adam MA, Adibe OO, Rice HE, Roman SA, et al. Predictors of nodal metastasis in pediatric differentiated thyroid cancer. J Pediatr Surg. 2017;52(1):120-3.
Reddy RM, Grigsby PW, Moley JF, Hall BL. Lymph node metastases in differentiated thyroid cancer under 2 cm. Surgery. 2006;140(6):1050-5.
Koo BS, Choi EC, Park YH, Kim EH. Occult contralateral central lymph node metastases in papillary thyroid carcinoma with unilateral lymph node metastasis in the lateral neck. J Am Collateral Surg. 2010;210:895-900.
Kasai N, Sakamoto A. New subgrouping of small thyroid carcinomas. Cancer. 1987;60:1767-70.
Spriano G, Ruscito P, Pellini R, Appetecchia M, Roselli R. Pattern of regional metastases and prognostic factors in differentiated thyroid carcinoma. Acta Otorhinolaryngol Ital. 2009;29(6):312-6.
Downloads
Published
How to Cite
Issue
Section
