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Objectives: The most common subtype of thyroid cancer is papillary thyroid cancer (PTC); lymph node metastases are common in this disease. Factors affecting the development of central lymph metastasis of PTC determine the treatment modality and prognosis of the disease. In this study, we aimed to evaluate the clinicopathologic features affecting the development of central lymph node metastasis. Methods: The data of a total of 346 PTC patients who were operated between May 2012 and September 2020 in our clinic and whose follow-up could be reached were evaluated retrospectively. Demographic data, surgical treatment modalities, and histopathological data of all patients were evaluated as a result of at least 6 months of follow-up. Patients age, sex, body mass index, pre-operative TSH levels, anti-TPO, and anti-Tg values at the time of diagnosis, whether lymph node dissection is performed, presence of lymph node metastasis, presence of distant metastasis, stage at the time of diagnosis (TNM 8th edition), ATA risk group at the time of diagnosis, multifocal and/or multicentric (bilaterality), largest tumor size, aggressive histological subtype, lymphovascular invasion of the tumor, extrathyroidal invasion, presence of lymphocytic thyroiditis, and surgical margin positivity were evaluated retrospectively. Results: In the development of PTC central metastasis, distant metastasis, tumor size, multifocality, multicentricity, presence of lymphovascular invasion, aggressive tumor subtype, presence of lateral metastasis, nodular goiter, and extrathyroidal spread were found to be effective. Among these factors, T stage, presence of lymphovascular invasion, and multicentricity were identified as independent risk factors for the development of central metastasis. Conclusion: Today, the investigation of predictive factors for the development of nodal metastasis in PTC does not seem to be out of date anytime soon. In our study, T stage, presence of lymphovascular invasion, and multicentricity were identified as independent risk factors for the development of central metastasis from the histopathological features of the tumor in PTC and of these features, T stage and multicentricity can be predicted by pre-operative imaging in many patients and can be used to decide whether to perform prophylactic SLN dissection in patients. However, new studies are still needed on this issue, in the literature.
Purpose: The most common undertype of thyroid cancer is thyroid cancer; lymphatic metastases are frequently observed. Factors affecting the development of central lymphatic metastasis in papillary thyroid cancer (PTK) determine the form of treatment and prognosis of the disease. In this study we also aimed at evaluating the effective clinic pathological characteristics on the development of central lymphatic nod metastasis. The data of a total of 346 patients diagnosed with papillary thyroid cancer operated in our clinic between May 2012 and September 2020 and available to follow-up were retrospective. All patients’ age, gender, body mass ratio, preoperative TSH levels, immediate diagnosis anti-TPO and anti-Tg values, lymphatic nod disection is done or not, the presence of lymphatic nod metastasis, the presence of distant metastasis, the immediate diagnosis stage (TNM 8th print), the immediate diagnosis ATA risk group, the tumor is multifocal and/or multisentric (bilaterality), the largest tumor size, the aggressive histological subtype, the tumor lymphatic invasion, the extratiroidal invasion, the presence of lymphatic thyroiditis, the surgical limit positive characteristics are retrospective. The findings: in the development of PTK central metastases; the presence of distant metastases, tumor diameter, multifocality, multisentricity (bilaterality), the presence of lymphovascular invasion, the subtype of the tumor is aggressive, the presence of lateral metastases, the nodular guatr and extratiroidal spread have been found to be effective. These factors were determined as independent risk factors for stage T, the presence of lymphovascular invasion and the development of multisentricity central metastasis. Result: Today, the study of predictive factors for the development of nodal metastases in PTK does not seem to lose its up-to-date in the near future. In our study, the histopathological characteristics of the tumor in PTK have been determined as independent risk factors for the development of the stage T, the presence of lymphovascular invasion and multisentricity center metastasis, and these factors can be predicted with preoperative imaging in many patients, especially in the stage T and multisentricity, and can be used in determining whether the prophylactic center lymph nod disection is performed in patients. However, in the literature there is still a need for new studies on this subject. (SETB-2022-08-186)
Alan : Sağlık Bilimleri
Dergi Türü : Ulusal
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