Metastatic Neck Disease in Multifocal Thyroid Papillary Cancer
PDF
Cite
Share
Request
Original Article
P: 313-317
December 2018

Metastatic Neck Disease in Multifocal Thyroid Papillary Cancer

Med Bull Haseki 2018;56(4):313-317
1. Acıbadem Mehmet Ali Aydınlar Üniversitesi Tıp Fakültesi, Kulak Burun Boğaz Hastalıkları Anabilim Dalı, İstanbul, Türkiye
2. Acıbadem Maslak Hastanesi, Genel Cerrahi Kliniği, İstanbul, Türkiye
3. Acıbadem Mehmet Ali Aydınlar Üniversitesi Tıp Fakültesi, Patoloji Anabilim Dalı, İstanbul, Türkiye
No information available.
No information available
Received Date: 29.08.2018
Accepted Date: 06.09.2018
Publish Date: 04.01.2019
PDF
Cite
Share
Request

ABSTRACT

Conclusion:

We recommend bilateral total thyroidectomy and bilateral central neck dissection as primary surgical treatment in multifocal thyroid cancer patients.

Results:

We compared multifocal and unifocal papillary thyroid cancer patients considering papillary thyroid capsule invasion (29.9%/10.86%), mean tumor diameter (15.9 mm/16.1 mm), central lymph node metastasis (56.5%/18.3%) and lateral neck lymph node metastasis (23.1%/6.3%). Capsule invasion was associated with an increased risk of multifocal disease. The incidence of capsular invasion and central and lateral neck metastases in MPTC patients was statistically significantly higher than in patients with unifocal thyroid papillary cancer (p<0.001).

Methods:

We retrospectively investigated the records of 2530 patients who underwent thyroidectomy for papillary thyroid cancer between January 2010 and December 2017. The age, gender, tumor size, thyroid capsule invasion and neck metastatic disease were evaluated in 515 of these patients having MPTC.

Aim:

Multifocal papillary thyroid cancer (MPTC) has aggressive and poor prognosis. The main aim of this study was to evaluate the lymph node metastasis pattern in MPTC patients.

References

1
Morris LG, Sikora AG, Tosteson TD, Davies L. The increasing incidence of thyroid cancer: the influence of access to care. Thyroid 2013;23:885-91.
2
Conzo G, Calò PG, Sinisi AA, et al. Impact of prophylactic central compartment neck dissection on locoregional recurrence of differentiated thyroid cancer in clinically node-negative patients: a retrospective study of a large clinical series. Surgery 2014;155:998-1005.
3
Li N, Du XL, Reitzel LR, et al. Impact of enhanced detection on the increase in thyroid cancer incidence in the United States: review of incidence trends by socioeconomic status within the Surveillance, Epidemiology and End Results registry, 1980-2008. Thyroid 2013;23:103-10.
4
Davies L, Welch HG. Increasing incidence of thyroid cancer in the United States, 1973-2002. JAMA 2006;295:2164-7.
5
Kuo SF, Lin SF, Chao TC, et al. Prognosis of multifocal papillary thyroid carcinoma. Int J Endocrinol 2013;2013:809382.
6
Hughes CJ, Shaha AR, Shah JP, Loree TR. Impact of lymph node metastasis in differentiated carcinoma of the thyroid: a matched-pair analysis. Head Neck 1996;18:127-32.
7
Lu Z, Sheng J, Zhang Y, et al. Clonality analysis of multifocal papillary thyroid carcinoma by using genetic profiles. J Pathol 2016;239:72-83.
8
Shaha AR, Shah JP, Loree TR. Patterns of nodal and distant metastasis based on histologic varieties in differentiated carcinoma of the thyroid. Am J Surg 1996;172:692-4.
9
Tam AA, Özdemir D, Çuhacı N, et al. Association of multifocality, tumor number, and total tumor diameter with clinicopathological features inpapillary thyroid cancer. Endocrine 2016;53:774-83.
10
Grodski S, Cornford L, Sywak M, et al. Routine level VI lymph node dissection for papillary thyroid cancer: surgical technique. ANZ J Surg 2007;77:203-8.
11
Caron NR, Clark OH. Papillary thyroid cancer: surgical management of lymph node metastases. Curr Treat Options Oncol 2005;6:311-22.
12
Malterling R. R., Andersson R. E., Falkmer S., Falkmer U., Niléhn E., Jrhult J. Differentiated thyroid cancer in a Swedish county—long-term results and quality of life. Acta Oncologica 2010;49:454-9.
13
Marcy PY, Thariat J, Peyrottes I, et al. Fulminant lethal spread of occult papillary microcarcinoma of the thyroid. Thyroid 2010;20:445-8.
14
Qu N, Zhang L, Ji QH, et al. Number of tumor foci predicts prognosis in papillary thyroid cancer. BMC Cancer 2014;14:914.
15
Wang Q, Chu B, Zhu J, et al. Clinical analysis of prophylactic central neck dissection for papillary thyroid carcinoma. Clinical and Translational Oncology 2014;16:44-8.
16
Podnos YD, Smith D, Wagman LD, et al. The implication of lymph node metastasis on survival inpatients with well-differentiated thyroid cancer. Am Surg 2005;71:731-4.
17
Leboulleux S, Rubino C, Baudin E, et al. Prognostic factors for persistent or recurrent disease of papillary thyroid carcinoma with neck lymph node metastases and/or tumor extension beyond the thyroid capsule at initial diagnosis. J Clin Endocrinol Metab 2005;90:5723-9.
18
Lundgren CI,Hall P, Dickman PW, et al. Clinically significant prognostic factors for differentiated thyroid carcinoma: a population- based, nested case-control study. Cancer 2006;106:524-31.
19
Riss JC, Peyrottes I, Chamorey E, et al. Prognostic impact of tumour multifocality in thyroid papillary microcarcinoma based on a series of 160 cases. Eur Ann Otorhinolaryngol Head Neck Dis 2012;129:175-8.
20
Hughes CJ, Shaha AR, Shah JP, et al. Impact of lymph node metastasis in differentiated carcinoma of the thyroid: a matched-pair analysis. Head Neck 1996;18:127-32.
21
Wang LY, Palmer FL, Nixon IJ, et al. Central lymph node characteristics predictive of outcome in patients with differentiated thyroid cancer. Thyroid 2014;24:1790-5.
22
Haugen BR, Alexander EK, Bible KC, et al. 2015 American Thyroid Association management guidelines for adult patients with thyroid nodules and differentiated thyroid cancer: the American Thyroid Association guidelines task force on thyroid nodules and differentiated thyroid cancer. Thyroid 2016;26:1-133.
23
Sancho JJ, Lennard TWJ, Paunovic I, et al. Prophylactic central neck disection in papillary thyroid cancer: a consensus report of the European Society of Endocrine Surgeons (ESES). Langenbecks Arch Surg 2014;399:155-63.
24
Ito Y, Uruno T, Nakano K, et al. An observation trial without surgical treatment in patients with papillary microcarcinoma of the thyroid. Thyroid 2003;13:381-7.
25
Song CM, Lee DW, Ji YB, et al. Frequency and pattern of central lymph node metastasis in papillary carcinoma of the thyroid isthmus. Head Neck 2015;38:E412-6.
26
Pellegriti G, Scollo C, Lumera G, Regalbuto C, Vigneri R, Belfiore A. Clinical behavior and outcome of papillary thyroid cancers smaller than 1.5 cm in diameter: study of 299 cases. J Clin Endocrinol Metab 2004;89:3713-20.
27
Chow SM, Law SCK, Chan JKC, Au SK, Yau S, Lau WH. Papillary microcarcinoma of the thyroid-prognostic significance of lymph node metastasis and multifocality. Cancer 2003;98:31-40.
28
Simon D, Goretzki PE, Witte J, Röher HD. Incidence of regional recurrence guiding radicality in differentiated thyroid carcinoma. World J Surg 1996;20:860-6.
29
Wang X, Cheng W, Liu C, et al. Tall cell variant of papillary thyroid carcinoma: current evidence on clinicopathologic features and molecular biology. Oncotarget 2016;7:40792-9.