1.Surgical management of gland and central compartment lymph node in papillary thyroid carcinoma
Xiaoyi LI ; Yunwei DONG ; Shenbao HU
Chinese Journal of Endocrine Surgery 2017;11(4):268-271
The incidence of papillary thyroid carcinoma (PTC) has been increasing in the past decades.The overall survival (OS) of most PTC patients is satisfied,however,recurrence is not rare.Surgical management is the basic treatment for PTC.The first step of surgery includes gland resection and lymph node dissection of central compartment.Several controversies remain in the indications and range of surgery.In this article,the progress of gland management,lymph node dissection in central compartment and complications in PTC/papillary thyroid microcarcinoma were reviewed.
2. Related factors analysis for lymph node metastasis in papillary thyroid carcinoma: a series of 2 073 patients
Qinghe SUN ; Lei ZHANG ; Jinbao YANG ; Yuewu LIU ; Feng LIANG ; Hua SHI ; Ziwen LIU ; Ge CHEN ; Shuguang CHEN ; Zhonghua SHANG ; Shenbao HU ; Yunwei DONG ; Yanlong LI ; Xiaoyi LI
Chinese Journal of Surgery 2017;55(8):592-598
Objective:
To investigate the related factors for lymph node metastasis (LNM), especially for high volume LNM (>5 metastatic lymph nodes) in papillary thyroid carcinoma (PTC).
Methods:
The medical records of 2 073 consecutive PTC patients who underwent lobectomy, near-total thyroidectomy or total thyroidectomy with ipsilateral or bilateral central lymph node dissection in Department of General Surgery, Peking Union Medical College Hospital from November 2013 to October 2014 were reviewed. Clinical and pathological features were collected. Univariate and multivariate analysis were performed to identify the related factors for LNM/high volume LNM.
Results:
In all 2 073 patients, LNM and high volume LNM were confirmed in 936 (45.15%) cases and 254 (12.25%) cases respectively. In univariate analysis, large tumor size, young patients (<40 years), male were associated with both LNM and high volume LNM. In multivariate analysis, tumor size >2.0 cm, young patients (<40 years), male were independent related factors of LNM (
3.Clinicopathologic features and risk factors for lymph node metastasis of papillary thyroid carcinoma with chronic lymphocytic thyroiditis
Yunwei DONG ; Chunhao LIU ; Shenbao HU ; Lei ZHANG ; Jinbao YANG ; Yuewu LIU ; Feng LIANG ; Hua SHI ; Ziwen LIU ; Ge CHEN ; Shuguang CHEN ; Zhonghua SHANG ; Qinghe SUN ; Yanlong LI ; Xiaoyi LI
Chinese Journal of General Surgery 2019;34(3):225-229
Objective To summarize clinicopathologic features of papillary thyroid carcinoma (PTC) coexistent with chronic lymphocytic thyroiditis (CLT) and investigate risk factors for lymph node metastasis.Methods The medical records of 4 264 consecutive papillary thyroid carcinoma patients who received surgical treatment from Oct 2013 to Oct 2015 in Peking Union Medical College Hospital were reviewed.The diagnoses was confirmed by histopathological tests.Univariate analysis was performed to identify specific clinicopathologic features of PTC with CLT.Univariate and multivariate analysis were performed to determine whether each clinicopathologic feature was an independent risk factor for lymph node metastasis.Results In all 4 265 cases,there were 3 059 papillary thyroid microcarcinoma (PTMC) (71.7%),1 010 PTC patients (23.7%) with CLT.909 female patients (90%),624 cases with multifocal lesions (61.8%),422 cases with extra-thyroid extension (41.8%),429 cases with lymph node metastasis (42.5%),and 133 cases with metastatic lymph nodes(LNs) ≥6 (13.2%).The median age was 43 years old and median tumor size was 0.8 cm.Patients with CLT were more females (90.0% vs.70.2%;P < 0.001),younger median age (43 vs.44 years;P =0.001),and lower incidence of lymph node metastasis (42.5% vs.50.9%;P <0.001).CLT was not associated with tumor size,multifocal lesions,extra-thyroid extension and metastatic LNs≥6 (0.8 cm vs.0.7 cm,61.8% vs.62.9%,41.8% vs.42.1% and 13.2% vs.14.8%,respectively,all P > 0.05).In multivariate analysis,CLT was an independent protective factor for lymph node metastasis (OR =0.713,95% CI 0.609-0.835,P <0.001).In PTC patients with lymph node metastasis,CLT was not associated with lymph node metastasis number (3 vs.3,P =0.300).Conclusions Chronic lymphocytic thyroiditis was an independent protective factor for papillary thyroid carcinoma patients with lymph node metastasis.But in patients with lymph node metastasis,the metastatic number didn't decrease.