Skip to main content
SpringerLink
Log in

Clinicopathologic risk factors for right paraesophageal lymph node metastasis in patients with papillary thyroid carcinoma

  • Original Article
  • Published:
Journal of Endocrinological Investigation Aims and scope Submit manuscript

Abstract

Objectives

To investigate risk factors associated with right paraesophageal lymph node (RPELN) metastasis in patients with papillary thyroid carcinoma (PTC) and to determine the indications for right lymph node dissection.

Methods

Clinicopathologic data from 829 patients (104 men and 725 women) with PTC, operated on by the same thyroid surgery team at the First Affiliated Hospital of Harbin Medical University from January 2013 to May 2017, were analyzed. Overall, 309 patients underwent total thyroidectomy with bilateral lymph node dissection, 488 underwent right thyroid lobe and isthmic resection with right central compartment lymph node dissection, and 32 underwent near-total thyroidectomy (ipsilateral thyroid lobectomy with contralateral near-total lobectomy) with bilateral lymph node dissection.

Results

The overall rate of central compartment lymph node metastasis was 43.5% (361/829), with right central compartment lymph node and RPELN metastasis rates of 35.5% (294/829) and 19.1% (158/829), respectively. Tumor size, number, invasion, and location, lymph node metastasis, right central compartment lymph node metastasis, and right lateral compartment lymph node metastasis were associated with RPELN in the univariate analysis, whereas age and sex were not. Multivariate analysis identified tumors with a diameter ≥ 1 cm, multiple tumors, tumors located in the right lobe, right central compartment lymph node metastasis, and right lateral compartment lymph node metastasis as independent risk factors for RPELN metastasis.

Conclusions

Lymph node dissection, including RPELN dissection, should be performed for patients with PTC with a tumor diameter ≥ 1 cm, multiple tumors, right-lobe tumors, right central compartment lymph node metastasis, or suspected lateral compartment lymph node metastasis.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Subscribe and save

Springer+ Basic
$34.99 /Month
  • Get 10 units per month
  • Download Article/Chapter or eBook
  • 1 Unit = 1 Article or 1 Chapter
  • Cancel anytime
Subscribe now

Buy Now

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Fig. 1
Fig. 2

Similar content being viewed by others

Abbreviations

OR:

Odds ratio

CI:

Confidence interval

PTC:

Papillary thyroid carcinoma

RPELN:

Right paraesophageal lymph node

rCLN:

Right central compartment lymph node

LLN:

Lateral compartment lymph node

References

  1. Howlader N, Noone AM, Krapcho M, Miller D, Bishop K, Altekruse SF, Kosary CL, Yu M, Ruhl J, Tatalovich Z, Mariotto A, Lewis DR, Chen HS, Feuer EJ, Cronin KA (eds). SEER cancer statistics review, 1975-2013, National Cancer Institute. Bethesda, MD, https://seer.cancer.gov/csr/1975_2013/, based on November 2015 SEER data submission, posted to the SEER web site, April 2016

  2. Jung KW, Won YJ, Kong HJ et al (2014) Cancer statistics in Korea: incidence, mortality, survival, and prevalence in 2011. Cancer Res Treat 46:109–123. https://doi.org/10.4143/crt.2014.46.2.109

    Article  PubMed  PubMed Central  Google Scholar 

  3. Hundahl SA, Fleming ID, Fremgen AM, Menck HR (1998) A National cancer data base report on 53,856 cases of thyroid carcinoma treated in the US, 1985–1995 [see comments]. Cancer 83:2638–2648

    Article  CAS  Google Scholar 

  4. Cooper DS, Doherty GM, Haugen BR et al (2009) Revised American Thyroid Association management guidelines for patients with thyroid nodules and differentiated thyroid cancer. Thyroid 19:1167–1214. https://doi.org/10.1089/thy.2009.0110

    Article  PubMed  Google Scholar 

  5. Gimm O, Rath FW, Dralle H (1998) Pattern of lymph node metastases in papillary thyroid carcinoma. Br J Surg 85:252–254. https://doi.org/10.1046/j.1365-2168.1998.00510.x

    Article  CAS  PubMed  Google Scholar 

  6. Machens A, Hinze R, Thomusch O, Dralle H (2002) Pattern of nodal metastasis for primary and reoperative thyroid cancer. World J Surg 26:22–28. https://doi.org/10.1007/s00268-001-0176-3

    Article  PubMed  Google Scholar 

  7. Russo M, Malandrino P, Moleti M et al (2017) Tall cell and diffuse sclerosing variants of papillary thyroid cancer: outcome and predicting value of risk stratification methods. J Endocrinol Invest 40:1235–1241. https://doi.org/10.1007/s40618-017-0688-9

    Article  CAS  PubMed  Google Scholar 

  8. Pinyi Z, Bin Z, Jianlong B et al (2014) Risk factors and clinical indication of metastasis to lymph nodes posterior to right recurrent laryngeal nerve in papillary thyroid carcinoma: a single-center study in China. Head Neck 36:1335–1342. https://doi.org/10.1002/hed.23451

    Article  PubMed  Google Scholar 

  9. Yuan J, Li J, Chen X et al (2017) Predictors of lymph nodes posterior to the right recurrent laryngeal nerve metastasis in patients with papillary thyroid carcinoma: a retrospective study. Med 96:e7908. https://doi.org/10.1097/md.0000000000007908

    Article  Google Scholar 

  10. Castagna MG, Cantara S, Pacini F (2016) Reappraisal of the indication for radioiodine thyroid ablation in differentiated thyroid cancer patients. J Endocrinol Invest 39:1087–1094. https://doi.org/10.1007/s40618-016-0503-z

    Article  CAS  Google Scholar 

  11. Pacini F, Brianzoni E, Durante C et al (2016) Recommendations for post-surgical thyroid ablation in differentiated thyroid cancer: a 2015 position statement of the Italian Society of Endocrinology. J Endocrinol Invest 39:341–347. https://doi.org/10.1007/s40618-015-0375-7

    Article  CAS  Google Scholar 

  12. Ito Y, Kudo T, Kobayashi K et al (2012) Prognostic factors for recurrence of papillary thyroid carcinoma in the lymph nodes, lung, and bone: analysis of 5768 patients with average 10-year follow-up. World J Surg 36:1274–1278. https://doi.org/10.1007/s00268-012-1423-5

    Article  PubMed  Google Scholar 

  13. Gao M, Ge M, Ji Q et al (2017) 2016 Chinese expert consensus and guidelines for the diagnosis and treatment of papillary thyroid microcarcinoma. Cancer Biol Med 14:203–211. https://doi.org/10.20892/j.issn.2095-3941.2017.0051

    Article  PubMed  PubMed Central  Google Scholar 

  14. Lee BJ, Lee JC, Wang SG et al (2009) Metastasis of right upper para-esophageal lymph nodes in central compartment lymph node dissection of papillary thyroid cancer. World J Surg 33:2094–2098. https://doi.org/10.1007/s00268-009-0149-5

    Article  PubMed  Google Scholar 

  15. Bae SY, Yang JH, Choi MY et al (2012) Right paraesophageal lymph node dissection in papillary thyroid carcinoma. Ann Surg Oncol 19:996–1000. https://doi.org/10.1245/s10434-011-2144-y

    Article  PubMed  Google Scholar 

  16. Kim YS, Park WC (2012) Clinical predictors of right upper paraesophageal lymph node metastasis from papillary thyroid carcinoma. World J Surg Oncol 10:164. https://doi.org/10.1186/1477-7819-10-164

    Article  PubMed  PubMed Central  Google Scholar 

  17. Ito Y, Fukushima M, Higashiyama T et al (2013) Incidence and predictors of right paraesophageal lymph node metastasis of N0 papillary thyroid carcinoma located in the right lobe. Endocr J 60:389–392

    Article  Google Scholar 

  18. Zhang L, Liu H, Xie Y et al (2016) Risk factors and indication for dissection of right paraesophageal lymph node metastasis in papillary thyroid carcinoma. Eur J Surg Oncol 42:81–86. https://doi.org/10.1016/j.ejso.2015.10.011

    Article  CAS  PubMed  Google Scholar 

  19. Liu Z, Sun M, Xiao Y et al (2017) Predictors of metastasis to lymph nodes posterior to the right recurrent laryngeal nerve in differentiated thyroid carcinoma: a prospective study. Asian J Surg 40:270–277. https://doi.org/10.1016/j.asjsur.2015.12.003

    Article  PubMed  Google Scholar 

  20. Park YM, Lee SM, Kim DW et al (2017) Predictive factors of right paraesophageal lymph node metastasis in papillary thyroid carcinoma: single center experience and meta-analysis. PLoS One 12:e0177956. https://doi.org/10.1371/journal.pone.0177956

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  21. Glattre E, Kravdal O (1994) Male and female parity and risk of thyroid cancer. Int J Cancer 58:616–617

    Article  CAS  Google Scholar 

  22. Sapuppo G, Palermo F, Russo M et al (2017) Latero-cervical lymph node metastases (N1b) represent an additional risk factor for papillary thyroid cancer outcome. J Endocrinol Invest 40:1355–1363. https://doi.org/10.1007/s40618-017-0714-y

    Article  CAS  PubMed  Google Scholar 

  23. Shattuck TM, Westra WH, Ladenson PW, Arnold A (2005) Independent clonal origins of distinct tumor foci in multifocal papillary thyroid carcinoma. N Engl J Med 352:2406–2412. https://doi.org/10.1056/NEJMoa044190

    Article  CAS  PubMed  Google Scholar 

  24. Park SY, Park YJ, Lee YJ et al (2006) Analysis of differential BRAF(V600E) mutational status in multifocal papillary thyroid carcinoma: evidence of independent clonal origin in distinct tumor foci. Cancer 107:1831–1838. https://doi.org/10.1002/cncr.22218

    Article  CAS  PubMed  Google Scholar 

Download references

Author information

Authors and Affiliations

  1. Department of Thyroid Surgery, The First Affiliated Hospital Harbin Medical University, Harbin, 150001, Heilongjiang, China

    Q. A. Yu, D. K. Ma, K. P. Liu, C. M. Xie, Y. H. Wu & W. J. Dai

  2. Department of Liver Surgery, The First Affiliated Hospital Harbin Medical University, Harbin, 150001, Heilongjiang, China

    Q. A. Yu & H. C. Jiang

  3. Operating Room, The First Affiliated Hospital Harbin Medical University, Harbin, 150001, China

    P. Wang

Authors
  1. Q. A. Yu
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. D. K. Ma
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. K. P. Liu
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. P. Wang
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. C. M. Xie
    View author publications

    You can also search for this author in PubMed Google Scholar

  6. Y. H. Wu
    View author publications

    You can also search for this author in PubMed Google Scholar

  7. W. J. Dai
    View author publications

    You can also search for this author in PubMed Google Scholar

  8. H. C. Jiang
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding authors

Correspondence to W. J. Dai or H. C. Jiang.

Ethics declarations

Conflict of interest

The authors declare that they have no conflict of interests or financial interest invested in this work.

Ethical approval

This study was approved by the ethics committee of First Ailiated Hospital of Harbin Medical University. All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.

Informed consent

For this type of study formal consent is not required.

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Yu, Q.A., Ma, D.K., Liu, K.P. et al. Clinicopathologic risk factors for right paraesophageal lymph node metastasis in patients with papillary thyroid carcinoma. J Endocrinol Invest 41, 1333–1338 (2018). https://doi.org/10.1007/s40618-018-0874-4

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s40618-018-0874-4

Keywords

Search

Navigation