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Risk factors of metastasis to the lymph nodes posterior to the right recurrent laryngeal nerve in papillary thyroid carcinoma

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Abstract

Purpose

To investigate the risk factors of lymph node posterior to the right recurrent laryngeal nerve (LN-prRLN) metastasis in papillary thyroid carcinoma.

Methods

Clinicopathologic feature data of 427 patients with right or double lobes who underwent surgery between January 2014 to August 2019 in the Department of General Surgery, Shanghai Jiao Tong University Affiliated Sixth People’s Hospital, were retrospectively analyzed. The risk factors of LN-prRLN metastasis were analyzed by the Chi-squared test and multivariate logistic regression.

Results

LN-prRLN metastasis was detected in 96 patients. Univariate analysis showed that age, right-side tumor diameter, capsular invasion, comorbid adenoma, and VIa compartment LN metastasis were significantly associated with LN-prRLN metastasis (all P < 0.05). Multivariate logistic regression analysis showed that right-side tumor diameter, capsular invasion, and VIa compartment LN metastasis were independent risk factors of LN-prRLN metastasis (all P ≤ 0.001). The receiver operating characteristic curve showed that the cutoff value of the right tumor diameter for predicting LN-prRLN metastasis was 1.25 cm (sensitivity = 0.5, specificity = 0.819, area under the curve = 0.720, P < 0.001).

Conclusion

The incidence of LN-prRLN metastasis cannot be ignored, and our findings indicate that prophylactic LN-prRLN dissection should be performed in patients with right-side tumor diameter ≥ 1.25 cm, capsular invasion, and VIa compartment LN metastasis.

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Acknowledgements

This work was supported by the National Natural Science Foundation of China (Grant number 81972543).

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Author notes

  1. Jianzhong Hou and Haojie Shan contributed equally to this work and should be considered as equal first coauthors.

Authors and Affiliations

  1. Department of General Surgery, Shanghai Jiao Tong University Affiliated Sixth People’s Hospital, Shanghai, 200233, China

    Jianzhong Hou, Yingchao Zhang, Youben Fan & Bo Wu

  2. Department of Orthopaedic Surgery, Shanghai Jiao Tong University Affiliated Sixth People’s Hospital, Shanghai, 200233, China

    Haojie Shan

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  1. Jianzhong Hou
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  2. Haojie Shan
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Correspondence to Youben Fan or Bo Wu.

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Hou, J., Shan, H., Zhang, Y. et al. Risk factors of metastasis to the lymph nodes posterior to the right recurrent laryngeal nerve in papillary thyroid carcinoma. Eur Arch Otorhinolaryngol 277, 881–886 (2020). https://doi.org/10.1007/s00405-019-05748-3

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  • DOI: https://doi.org/10.1007/s00405-019-05748-3

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