Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.
Recently, we have created a revised version of the eighth edition of the tumor–node–metastasis classification for papillary thyroid carcinomas (PTCs) by subdividing the T4a (T4a1 [moderate] and T4a2 [significant]) and N (N1 [N ≤ 3 cm] and N2 [N > 3 cm]) classifications. This re-staging better stratified patient outcomes. In this study, we investigated the prognostic significance of extranodal tumor extension (LNEx) in PTC.
Five thousand six hundred and eighty-three patients with PTC surgically treated in Kuma Hospital were enrolled. We evaluated LNEx based on intraoperative findings.
One hundred and twenty-seven patients (2%) displayed LNEx. In contrast to what we observed for extrathyroid extension, the prognostic value of LNEx did not change based on the organ that had been invaded, and we therefore analyzed LNEx patients as a single group. In patients aged 55 or older, LNEx independently affected patients’ prognoses, as did T4a2 and N2. The cancer-specific survival (CSS) of patients in Stage I but having LNEx demonstrated the similar prognosis to patients in Stage II. Further, in the subset analysis for Stage II patients aged 55 or older, LNEx had a significant prognostic value for CSS in both the univariate and multivariate analyses, as did N2. The CSS of Stage II patients aged 55 or older with LNEx did not differ from that of Stage III patients.
It is appropriate that, similar to T4a2 or N2 patients, LNEx-positive patients younger than 55 years in Stage I and those aged 55 or older in Stage II are re-staged to II and III, respectively.
Amin MB, Edge S, Greene F et al (eds) (2017) AJCC cancer staging manual (8th). Springer, New York
Edge S, Byrd DR, Compton CC et al (eds) (2010) AJCC cancer staging manual (7th). Springer, New York
Ito Y, Miyauchi A, Hirokawa M et al (2018) Prognostic value of the 8th edition of the tumor-node-metastasis classification for patients with papillary thyroid carcinoma: a single-institution study at a high-volume center in Japan. Endocr J 65:707–718 CrossRef
Nam SH, Bae MR, Roh JL et al (2018) A comparison of the 7th and 8th editions of the AJCC staging system in terms of predicting recurrence and survival in patients with papillary thyroid carcinoma. Oral Oncol 87:158–164 CrossRef
Nava CF, Zanella AB, Scheffei RS et al (2019) Impact of the updated TNM staging criteria on prediction of persistent disease in a differentiated thyroid carcinoma cohort. Arch Endocrinol Metab 63:5–11 CrossRef
Ito Y, Miyauchi A, Kihara M et al (2019) Subclassification of tumor extension and nodal metastasis in papillary thyroid cancer to improve prognostic accuracy of the eighth edition of the tumor-node-metastasis classification. World J Surg. https://doi.org/10.1007/s00268-019-05120-w (Epub ahead of print) CrossRefPubMed
Alpert EH, Wenig BM, Dewey EH et al (2015) Size distribution of metastatic lymph nodes with extranodal extension in patients with papillary thyroid cancer: a pilot study. Thyroid 25:238–241 CrossRef
Wu MH, Shen WT, Gosnell J et al (2015) Prognostic significance of extranodal extension of regional lymph node metastasis in papillary thyroid cancer. Head Neck 37:1336–1343 CrossRef
Suh S, Pak K, Seok JW et al (2016) Prognostic value of extranodal extension in thyroid cancer: a meta-analysis. Yonsei Med J 57:1324–1328 CrossRef
Kim JW, Roh JL, Gong G et al (2017) Extent of extrathyroidal extension as a significant predictor of nodal metastasis and extranodal extension in patients with papillary thyroid carcinoma. Ann Surg Oncol 24:460–468 CrossRef
Roh JL, Park JW, Jeong J et al (2017) Extranodal extension of lymph node metastasis as a prognostic indicator of recurrence and survival in papillary thyroid carcinoma. J Surg Oncol 116:450–458 CrossRef
Haugen BR, Alexander EK, Bible KC et al (2016) 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 26:1–133 CrossRef
- Prognostic Value of Extranodal Tumor Extension in Papillary Thyroid Carcinoma: Proposal for Upstaging of Cases with Extranodal Tumor Extension
- Springer International Publishing
World Journal of Surgery
Official Journal of the International Society of Surgery/Société Internationale de Chirurgie
Print ISSN: 0364-2313
Elektronische ISSN: 1432-2323
Neu im Fachgebiet Chirurgie
e.Med Kampagnen-Visual, Mail Icon II