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Predictive Factors of Lymph Node Metastasis in Follicular Variant of Papillary Thyroid Carcinoma

  • Endocrine Tumors
  • Published:
Annals of Surgical Oncology Aims and scope Submit manuscript

Abstract

Background

Compared with conventional papillary thyroid carcinoma (PTC), follicular variant of PTC (FV-PTC) shows less aggressive behavior and better prognosis. Nonetheless, regional lymph node (LN) metastasis was found in 22.8% of FV-PTC patients. Because LN metastasis is a proven predictor of recurrence in PTC, it is important to assess LN metastasis in FV-PTC patients.

Methods

We retrospectively reviewed 134 FV-PTC patients who underwent thyroidectomy with neck dissection.

Results

Central LN metastasis (CLNM) and lateral LN metastasis (LLNM) were found in 50 (37.3%) and 16 (11.9%) patients, respectively. In the multivariate analysis for CLNM, male sex (adjusted OR 4.735, p = 0.001), nonencapsulated form (adjusted OR 2.863, p = 0.022), and tumor size >1.0 cm (adjusted OR 3.157, p = 0.008) were independent predictors of high prevalence of CLNM in FV-PTC patients. In the multivariate analysis for LLNM, microscopic extrathyroidal extension (ETE) (adjusted OR 3.939, p = 0.041) and CLNM (adjusted OR 13.340, p = 0.001) were independent predictors of high prevalence of LLNM in FV-PTC patients.

Conclusions

Meticulous perioperative evaluation and prophylactic central neck dissection may be beneficial for FV-PTC patients with male sex, nonencapsulated form, and tumor size >1.0 cm. Moreover, cautious perioperative evaluation of lateral neck LN may be mandatory for FV-PTC patients with microscopic ETE and CLNM.

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Disclosure

The authors have nothing to declare.

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Authors and Affiliations

  1. Division of Breast and Endocrine Surgery, Department of Surgery, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, South Korea

    Seo Ki Kim MD, Kyorim Back MD, Inhye Park MD, Nayoon Hur MD, Jun-Ho Choe MD, PhD, Jung-Han Kim MD, PhD & Jee Soo Kim MD, PhD

  2. Department of Pathology, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, South Korea

    Ah-Young Kwon MD & Young Lyun Oh MD, PhD

  3. Division of Breast and Endocrine Surgery, Department of Surgery, Samsung Changwon Hospital, Sungkyunkwan University School of Medicine, Changwon, South Korea

    Jun Ho Lee MD

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  1. Seo Ki Kim MD
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  2. Ah-Young Kwon MD
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  3. Kyorim Back MD
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  4. Inhye Park MD
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  5. Nayoon Hur MD
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  6. Jun Ho Lee MD
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  7. Jun-Ho Choe MD, PhD
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  8. Jung-Han Kim MD, PhD
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  10. Jee Soo Kim MD, PhD
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Corresponding authors

Correspondence to Jun-Ho Choe MD, PhD or Jee Soo Kim MD, PhD.

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Kim, S.K., Kwon, AY., Back, K. et al. Predictive Factors of Lymph Node Metastasis in Follicular Variant of Papillary Thyroid Carcinoma. Ann Surg Oncol 24, 2617–2623 (2017). https://doi.org/10.1245/s10434-017-5912-5

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  • DOI: https://doi.org/10.1245/s10434-017-5912-5

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