Title: Clinical features and related factors of cervical lymph node metastasis of papillary thyroid carcinoma coexistent with Hashimoto’s thyroiditis
Abstract: Objective: To investigate the clinical features and related factors of cervical lymph node metastasis of papillary thyroid carcinoma coexistent with Hashimoto’s thyroiditis, and to provide clinical evidence when deciding cervical lymph node dissection. Methods: A total of 205 patients who were diagnosed of papillary thyroid carcinoma coexistent with Hashimoto’s thyroiditis and underwent surgery between January 2006 and December 2011 were enrolled in this study, and a retrospective review of the clinical features and related factors of cervical lymph node metastasis was performed. These patients all underwent a cervical lymph node dissection. Results: The percentage of patients with cervical lymph node metastasis was 52.7% (108/205), and the first lymph nodes to which lymph from the cancer site was likely to drain were cervical central lymph nodes. The rate of cervical central lymph node metastasis was higher than that of cervical lateral lymph node metastasis [50.2% (103/205) vs 15.1% (31/205), P ﹦ 0. 000]. The factors of gender (r = 0.009,P = 0.904), serum thyroid stimulating hormone level before surgery (r = –0.050,P = 0.536) and the number of primary tumor lesions (r = 0.119,P = 0.096) were not correlated with lymph node metastasis, but the age (r = –0.140,P = 0.043), primary tumor size (r = 0.185,P = 0.010) and extrathyroid extension (r = –0.340,P = 0.010) were correlated with lymph node metastasis. Conclusion: Central lymph node dissection should be carried out as a routine for the reason that papillary thyroid carcinoma coexistent with Hashimoto’s thyroiditis had a higher rate of cervical central lymph node metastasis. Dissection of lateral lymph node should be done prudentially for its higher false positive rate. The dissection of lateral lymph node should be considered to be done at the first time when the patients are diagnosed in childhood and adolescence or aged 45 years or over or have a larger tumor size or extrathyroid extension.
Publication Year: 2012
Publication Date: 2012-01-01
Language: en
Type: article
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