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Erschienen in: Annals of Surgical Oncology 2/2017

21.09.2016 | Endocrine Tumors

Extent of Extrathyroidal Extension as a Significant Predictor of Nodal Metastasis and Extranodal Extension in Patients with Papillary Thyroid Carcinoma

verfasst von: Ji Won Kim, MD, Jong-Lyel Roh, MD, PhD, Gyungyup Gong, MD, PhD, Kyung-Ja Cho, MD, PhD, Seung-Ho Choi, MD, PhD, Soon Yuhl Nam, MD, PhD, Sang Yoon Kim, MD, PhD

Erschienen in: Annals of Surgical Oncology | Ausgabe 2/2017

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Abstract

Background

Extrathyroidal extension (ETE) and extranodal extension (ENE) indicate poor prognosis for patients with papillary thyroid carcinoma (PTC). The relationships among ETE, ENE, and nodal metastasis (N1) have not been thoroughly studied. In this study, we examined the relationships among the extent of ETE, N1, ENE, and posttreatment recurrence in patients with PTC.

Methods

This study enrolled 1693 consecutive patients with previously untreated PTC who underwent thyroidectomy between 2006 and 2009. The extent of ETE was graded based on intraoperative and pathological findings, and central and lateral neck (N1b) nodal metastases and ENE were pathologically determined. Univariate and multivariate analyses were used to identify the association of clinicopathological factors with recurrence-free survival (RFS) and to define the relationships among the extent of ETE, N1, and ENE.

Results

Of 1693 patients, 1087 (64.2 %) had ETE and 201 (11.9 %) had ENE. Pathologically positive lymph nodes were found in 783 patients (46.2 %), of whom 236 (30.1 %) had N1b. During the median follow-up of 86 months, 90 (5.3 %) patients had recurrences. Multivariate analyses showed that multifocality, ETE, T and N classification, the risk of structural recurrence proposed by the American Thyroid Association, and ENE were independent variables for RFS (P < .05). Patients with macroscopic ETE had a 13-fold increased risk of recurrence, and ETE had significant relationships with N1, N1b, and ENE (all P < .001).

Conclusions

Local extension, nodal involvement, and ENE contribute to posttreatment recurrence of PTC. Macroscopic ETE predicts nodal metastasis and ENE, which are adverse pathologic features.
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Metadaten
Titel
Extent of Extrathyroidal Extension as a Significant Predictor of Nodal Metastasis and Extranodal Extension in Patients with Papillary Thyroid Carcinoma
verfasst von
Ji Won Kim, MD
Jong-Lyel Roh, MD, PhD
Gyungyup Gong, MD, PhD
Kyung-Ja Cho, MD, PhD
Seung-Ho Choi, MD, PhD
Soon Yuhl Nam, MD, PhD
Sang Yoon Kim, MD, PhD
Publikationsdatum
21.09.2016
Verlag
Springer International Publishing
Erschienen in
Annals of Surgical Oncology / Ausgabe 2/2017
Print ISSN: 1068-9265
Elektronische ISSN: 1534-4681
DOI
https://doi.org/10.1245/s10434-016-5594-4

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