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Clinical and Imaging Assessment of Cervical Lymph Node Metastasis in Papillary Thyroid Carcinomas
Background The goals of this study were to analyze clinical factors that affect cervical lymph node metastasis (LNM) in papillary thyroid cancer (PTC), and to evaluate the diagnostic accuracy of preoperative ultrasound (US) and computed tomography (CT) of the neck. Methods The study sample included...
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| Published in: | World journal of surgery 2010-07, Vol.34 (7), p.1494-1499 |
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| container_end_page | 1499 |
| container_issue | 7 |
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| container_title | World journal of surgery |
| container_volume | 34 |
| creator | Choi, Yoon Jung Yun, Ji Sup Kook, Shin Ho Jung, Eun Choel Park, Yong Lai |
| description | Background
The goals of this study were to analyze clinical factors that affect cervical lymph node metastasis (LNM) in papillary thyroid cancer (PTC), and to evaluate the diagnostic accuracy of preoperative ultrasound (US) and computed tomography (CT) of the neck.
Methods
The study sample included 589 consecutive patients who underwent surgery for PTC. Patient age and sex, number, size, and location of tumors, lymphovascular invasion, and extrathyroidal extension were evaluated as risk factors for central and lateral LNM.
Results
Increased risk of lymph node metastasis was found for male patients, 1 cm, lymphovascular invasion, and extrathyroidal invasion. Cancers located in the upper neck had a higher relative risk of lateral metastasis than cancers located in the lower neck. Sensitivity of both US and CT imaging was higher for lateral (70-80%) than for central (42-47%) LNM. Specificity of US and CT was high (92-97%) for both central and lateral LNM. Using central lymph node size of greater than 5 mm as an indicator of metastasis, preoperative US had 58.3% sensitivity and 71.4% specificity.
Conclusions
Preoperative US and CT imaging are useful for identifying features that indicate a high risk of LNM and for determining appropriate management of PTC. |
| doi_str_mv | 10.1007/s00268-010-0541-1 |
| format | article |
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The goals of this study were to analyze clinical factors that affect cervical lymph node metastasis (LNM) in papillary thyroid cancer (PTC), and to evaluate the diagnostic accuracy of preoperative ultrasound (US) and computed tomography (CT) of the neck.
Methods
The study sample included 589 consecutive patients who underwent surgery for PTC. Patient age and sex, number, size, and location of tumors, lymphovascular invasion, and extrathyroidal extension were evaluated as risk factors for central and lateral LNM.
Results
Increased risk of lymph node metastasis was found for male patients, <45 years old, with tumor size >1 cm, lymphovascular invasion, and extrathyroidal invasion. Cancers located in the upper neck had a higher relative risk of lateral metastasis than cancers located in the lower neck. Sensitivity of both US and CT imaging was higher for lateral (70-80%) than for central (42-47%) LNM. Specificity of US and CT was high (92-97%) for both central and lateral LNM. Using central lymph node size of greater than 5 mm as an indicator of metastasis, preoperative US had 58.3% sensitivity and 71.4% specificity.
Conclusions
Preoperative US and CT imaging are useful for identifying features that indicate a high risk of LNM and for determining appropriate management of PTC.</description><identifier>ISSN: 0364-2313</identifier><identifier>EISSN: 1432-2323</identifier><identifier>DOI: 10.1007/s00268-010-0541-1</identifier><identifier>PMID: 20372903</identifier><identifier>CODEN: WJSUDI</identifier><language>eng</language><publisher>New York: Springer-Verlag</publisher><subject>Abdominal Surgery ; Adolescent ; Adult ; Aged ; Aged, 80 and over ; Biological and medical sciences ; Carcinoma, Papillary - diagnostic imaging ; Carcinoma, Papillary - pathology ; Carcinoma, Papillary - surgery ; Cardiac Surgery ; Cervical Lymph Node Metastasis ; Endocrinopathies ; Extrathyroidal Extension ; Female ; General aspects ; General Surgery ; Hematologic and hematopoietic diseases ; Humans ; Leukemias. Malignant lymphomas. Malignant reticulosis. Myelofibrosis ; Logistic Models ; Lymph Node Metastasis ; Lymphatic Metastasis ; Male ; Malignant tumors ; Medical sciences ; Medicine ; Medicine & Public Health ; Middle Aged ; Neck - diagnostic imaging ; Neck Dissection ; Neoplasm Invasiveness ; Papillary Thyroid Cancer ; Radiography ; Risk Factors ; Sensitivity and Specificity ; Surgery ; Thoracic Surgery ; Thyroid Neoplasms - diagnostic imaging ; Thyroid Neoplasms - pathology ; Thyroid Neoplasms - surgery ; Thyroid. Thyroid axis (diseases) ; Thyroidectomy ; Ultrasonography ; Vascular Surgery ; Young Adult</subject><ispartof>World journal of surgery, 2010-07, Vol.34 (7), p.1494-1499</ispartof><rights>Société Internationale de Chirurgie 2010</rights><rights>2010 The Author(s) under exclusive licence to Société Internationale de Chirurgie</rights><rights>2015 INIST-CNRS</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c5168-89a14ad799e1402582605327de10213c4dd4b933cf6f34e87eed38a3fe3e2dad3</citedby><cites>FETCH-LOGICAL-c5168-89a14ad799e1402582605327de10213c4dd4b933cf6f34e87eed38a3fe3e2dad3</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><link.rule.ids>315,783,787,27936,27937</link.rule.ids><backlink>$$Uhttp://pascal-francis.inist.fr/vibad/index.php?action=getRecordDetail&idt=23015035$$DView record in Pascal Francis$$Hfree_for_read</backlink><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/20372903$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Choi, Yoon Jung</creatorcontrib><creatorcontrib>Yun, Ji Sup</creatorcontrib><creatorcontrib>Kook, Shin Ho</creatorcontrib><creatorcontrib>Jung, Eun Choel</creatorcontrib><creatorcontrib>Park, Yong Lai</creatorcontrib><title>Clinical and Imaging Assessment of Cervical Lymph Node Metastasis in Papillary Thyroid Carcinomas</title><title>World journal of surgery</title><addtitle>World J Surg</addtitle><addtitle>World J Surg</addtitle><description>Background
The goals of this study were to analyze clinical factors that affect cervical lymph node metastasis (LNM) in papillary thyroid cancer (PTC), and to evaluate the diagnostic accuracy of preoperative ultrasound (US) and computed tomography (CT) of the neck.
Methods
The study sample included 589 consecutive patients who underwent surgery for PTC. Patient age and sex, number, size, and location of tumors, lymphovascular invasion, and extrathyroidal extension were evaluated as risk factors for central and lateral LNM.
Results
Increased risk of lymph node metastasis was found for male patients, <45 years old, with tumor size >1 cm, lymphovascular invasion, and extrathyroidal invasion. Cancers located in the upper neck had a higher relative risk of lateral metastasis than cancers located in the lower neck. Sensitivity of both US and CT imaging was higher for lateral (70-80%) than for central (42-47%) LNM. Specificity of US and CT was high (92-97%) for both central and lateral LNM. Using central lymph node size of greater than 5 mm as an indicator of metastasis, preoperative US had 58.3% sensitivity and 71.4% specificity.
Conclusions
Preoperative US and CT imaging are useful for identifying features that indicate a high risk of LNM and for determining appropriate management of PTC.</description><subject>Abdominal Surgery</subject><subject>Adolescent</subject><subject>Adult</subject><subject>Aged</subject><subject>Aged, 80 and over</subject><subject>Biological and medical sciences</subject><subject>Carcinoma, Papillary - diagnostic imaging</subject><subject>Carcinoma, Papillary - pathology</subject><subject>Carcinoma, Papillary - surgery</subject><subject>Cardiac Surgery</subject><subject>Cervical Lymph Node Metastasis</subject><subject>Endocrinopathies</subject><subject>Extrathyroidal Extension</subject><subject>Female</subject><subject>General aspects</subject><subject>General Surgery</subject><subject>Hematologic and hematopoietic diseases</subject><subject>Humans</subject><subject>Leukemias. Malignant lymphomas. Malignant reticulosis. Myelofibrosis</subject><subject>Logistic Models</subject><subject>Lymph Node Metastasis</subject><subject>Lymphatic Metastasis</subject><subject>Male</subject><subject>Malignant tumors</subject><subject>Medical sciences</subject><subject>Medicine</subject><subject>Medicine & Public Health</subject><subject>Middle Aged</subject><subject>Neck - diagnostic imaging</subject><subject>Neck Dissection</subject><subject>Neoplasm Invasiveness</subject><subject>Papillary Thyroid Cancer</subject><subject>Radiography</subject><subject>Risk Factors</subject><subject>Sensitivity and Specificity</subject><subject>Surgery</subject><subject>Thoracic Surgery</subject><subject>Thyroid Neoplasms - diagnostic imaging</subject><subject>Thyroid Neoplasms - pathology</subject><subject>Thyroid Neoplasms - surgery</subject><subject>Thyroid. Thyroid axis (diseases)</subject><subject>Thyroidectomy</subject><subject>Ultrasonography</subject><subject>Vascular Surgery</subject><subject>Young Adult</subject><issn>0364-2313</issn><issn>1432-2323</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2010</creationdate><recordtype>article</recordtype><recordid>eNqFkF2L1DAUhoMo7uzoD_BGgiB7VT3JSdP2ci2urowf4IqXIduczmZp0zGZUebfm7GjC4IIgeTieU_e8zD2RMALAVC9TABS1wUIKKBUohD32EIolIVEiffZAlCr_BZ4wk5TugUQlQb9kJ1IwEo2gAtm28EH39mB2-D45WjXPqz5eUqU0khhy6eetxS__0JW-3Fzwz9Mjvh72tqUj0_cB_7Jbvww2LjnVzf7OHnHWxs7H6bRpkfsQW-HRI-P95J9uXh91b4tVh_fXLbnq6IrRV6ibqxQ1lVNQ0KBLGupoURZORIgBXbKOXXdIHa97lFRXRE5rC32hCSddbhkZ_PcTZy-7ShtzehTR7lWoGmXTIWoZX0ws2TP_iJvp10MuZzRgHVTaawyJGaoi1NKkXqziX7MKxoB5mDfzPZNtm8O9o3ImafHwbvrkdyfxG_dGXh-BGzKQvtoQ-fTHYcgSsAyc83M_fAD7f__s_n67vOrC1CNrnNWztmUY2FN8W67fzf_CQOFrA4</recordid><startdate>201007</startdate><enddate>201007</enddate><creator>Choi, Yoon Jung</creator><creator>Yun, Ji Sup</creator><creator>Kook, Shin Ho</creator><creator>Jung, Eun Choel</creator><creator>Park, Yong Lai</creator><general>Springer-Verlag</general><general>Springer‐Verlag</general><general>Springer</general><general>Springer Nature B.V</general><scope>IQODW</scope><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>3V.</scope><scope>7QO</scope><scope>7T5</scope><scope>7X7</scope><scope>7XB</scope><scope>88E</scope><scope>8AO</scope><scope>8FD</scope><scope>8FI</scope><scope>8FJ</scope><scope>8FK</scope><scope>ABUWG</scope><scope>AFKRA</scope><scope>BENPR</scope><scope>CCPQU</scope><scope>FR3</scope><scope>FYUFA</scope><scope>GHDGH</scope><scope>H94</scope><scope>K9.</scope><scope>M0S</scope><scope>M1P</scope><scope>P64</scope><scope>PQEST</scope><scope>PQQKQ</scope><scope>PQUKI</scope><scope>7X8</scope></search><sort><creationdate>201007</creationdate><title>Clinical and Imaging Assessment of Cervical Lymph Node Metastasis in Papillary Thyroid Carcinomas</title><author>Choi, Yoon Jung ; Yun, Ji Sup ; Kook, Shin Ho ; Jung, Eun Choel ; Park, Yong Lai</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c5168-89a14ad799e1402582605327de10213c4dd4b933cf6f34e87eed38a3fe3e2dad3</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2010</creationdate><topic>Abdominal Surgery</topic><topic>Adolescent</topic><topic>Adult</topic><topic>Aged</topic><topic>Aged, 80 and over</topic><topic>Biological and medical sciences</topic><topic>Carcinoma, Papillary - diagnostic imaging</topic><topic>Carcinoma, Papillary - pathology</topic><topic>Carcinoma, Papillary - surgery</topic><topic>Cardiac Surgery</topic><topic>Cervical Lymph Node Metastasis</topic><topic>Endocrinopathies</topic><topic>Extrathyroidal Extension</topic><topic>Female</topic><topic>General aspects</topic><topic>General Surgery</topic><topic>Hematologic and hematopoietic diseases</topic><topic>Humans</topic><topic>Leukemias. Malignant lymphomas. Malignant reticulosis. Myelofibrosis</topic><topic>Logistic Models</topic><topic>Lymph Node Metastasis</topic><topic>Lymphatic Metastasis</topic><topic>Male</topic><topic>Malignant tumors</topic><topic>Medical sciences</topic><topic>Medicine</topic><topic>Medicine & Public Health</topic><topic>Middle Aged</topic><topic>Neck - diagnostic imaging</topic><topic>Neck Dissection</topic><topic>Neoplasm Invasiveness</topic><topic>Papillary Thyroid Cancer</topic><topic>Radiography</topic><topic>Risk Factors</topic><topic>Sensitivity and Specificity</topic><topic>Surgery</topic><topic>Thoracic Surgery</topic><topic>Thyroid Neoplasms - diagnostic imaging</topic><topic>Thyroid Neoplasms - pathology</topic><topic>Thyroid Neoplasms - surgery</topic><topic>Thyroid. Thyroid axis (diseases)</topic><topic>Thyroidectomy</topic><topic>Ultrasonography</topic><topic>Vascular Surgery</topic><topic>Young Adult</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Choi, Yoon Jung</creatorcontrib><creatorcontrib>Yun, Ji Sup</creatorcontrib><creatorcontrib>Kook, Shin Ho</creatorcontrib><creatorcontrib>Jung, Eun Choel</creatorcontrib><creatorcontrib>Park, Yong Lai</creatorcontrib><collection>Pascal-Francis</collection><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>ProQuest Central (Corporate)</collection><collection>Biotechnology Research Abstracts</collection><collection>Immunology Abstracts</collection><collection>Health & Medical Collection</collection><collection>ProQuest Central (purchase pre-March 2016)</collection><collection>Medical Database (Alumni Edition)</collection><collection>ProQuest Pharma Collection</collection><collection>Technology Research Database</collection><collection>Hospital Premium Collection</collection><collection>Hospital Premium Collection (Alumni Edition)</collection><collection>ProQuest Central (Alumni) (purchase pre-March 2016)</collection><collection>ProQuest Central (Alumni)</collection><collection>ProQuest Central</collection><collection>ProQuest Central</collection><collection>ProQuest One Community College</collection><collection>Engineering Research Database</collection><collection>Health Research Premium Collection</collection><collection>Health Research Premium Collection (Alumni)</collection><collection>AIDS and Cancer Research Abstracts</collection><collection>ProQuest Health & Medical Complete (Alumni)</collection><collection>Health & Medical Collection (Alumni Edition)</collection><collection>PML(ProQuest Medical Library)</collection><collection>Biotechnology and BioEngineering Abstracts</collection><collection>ProQuest One Academic Eastern Edition (DO NOT USE)</collection><collection>ProQuest One Academic</collection><collection>ProQuest One Academic UKI Edition</collection><collection>MEDLINE - Academic</collection><jtitle>World journal of surgery</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Choi, Yoon Jung</au><au>Yun, Ji Sup</au><au>Kook, Shin Ho</au><au>Jung, Eun Choel</au><au>Park, Yong Lai</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Clinical and Imaging Assessment of Cervical Lymph Node Metastasis in Papillary Thyroid Carcinomas</atitle><jtitle>World journal of surgery</jtitle><stitle>World J Surg</stitle><addtitle>World J Surg</addtitle><date>2010-07</date><risdate>2010</risdate><volume>34</volume><issue>7</issue><spage>1494</spage><epage>1499</epage><pages>1494-1499</pages><issn>0364-2313</issn><eissn>1432-2323</eissn><coden>WJSUDI</coden><abstract>Background
The goals of this study were to analyze clinical factors that affect cervical lymph node metastasis (LNM) in papillary thyroid cancer (PTC), and to evaluate the diagnostic accuracy of preoperative ultrasound (US) and computed tomography (CT) of the neck.
Methods
The study sample included 589 consecutive patients who underwent surgery for PTC. Patient age and sex, number, size, and location of tumors, lymphovascular invasion, and extrathyroidal extension were evaluated as risk factors for central and lateral LNM.
Results
Increased risk of lymph node metastasis was found for male patients, <45 years old, with tumor size >1 cm, lymphovascular invasion, and extrathyroidal invasion. Cancers located in the upper neck had a higher relative risk of lateral metastasis than cancers located in the lower neck. Sensitivity of both US and CT imaging was higher for lateral (70-80%) than for central (42-47%) LNM. Specificity of US and CT was high (92-97%) for both central and lateral LNM. Using central lymph node size of greater than 5 mm as an indicator of metastasis, preoperative US had 58.3% sensitivity and 71.4% specificity.
Conclusions
Preoperative US and CT imaging are useful for identifying features that indicate a high risk of LNM and for determining appropriate management of PTC.</abstract><cop>New York</cop><pub>Springer-Verlag</pub><pmid>20372903</pmid><doi>10.1007/s00268-010-0541-1</doi><tpages>6</tpages></addata></record> |
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| subjects | Abdominal Surgery Adolescent Adult Aged Aged, 80 and over Biological and medical sciences Carcinoma, Papillary - diagnostic imaging Carcinoma, Papillary - pathology Carcinoma, Papillary - surgery Cardiac Surgery Cervical Lymph Node Metastasis Endocrinopathies Extrathyroidal Extension Female General aspects General Surgery Hematologic and hematopoietic diseases Humans Leukemias. Malignant lymphomas. Malignant reticulosis. Myelofibrosis Logistic Models Lymph Node Metastasis Lymphatic Metastasis Male Malignant tumors Medical sciences Medicine Medicine & Public Health Middle Aged Neck - diagnostic imaging Neck Dissection Neoplasm Invasiveness Papillary Thyroid Cancer Radiography Risk Factors Sensitivity and Specificity Surgery Thoracic Surgery Thyroid Neoplasms - diagnostic imaging Thyroid Neoplasms - pathology Thyroid Neoplasms - surgery Thyroid. Thyroid axis (diseases) Thyroidectomy Ultrasonography Vascular Surgery Young Adult |
| title | Clinical and Imaging Assessment of Cervical Lymph Node Metastasis in Papillary Thyroid Carcinomas |
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