Predictors of Central Compartment Involvement in Patients with Positive Lateral Cervical Lymph Nodes According to Clinical and/or Ultrasound Evaluation

Unit of General and Emergency Surgery, Department of Surgical Oncological and Oral Sciences, Policlinico P. Giaccone, University of Palermo, Via L Giuffré, 5, 90127 Palermo, Italy

Unit of Clinical Epidemiology & Tumor Registry, Department of Laboratory Diagnostics, Policlinico P. Giaccone, University of Palermo, Via L Giuffré, 5, 90127 Palermo, Italy

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Unit of Endocrine Surgery, Department of Surgical Oncological and Oral Sciences, Policlinico P. Giaccone, University of Palermo, Via L Giuffré, 5, 90127 Palermo, Italy

Author to whom correspondence should be addressed.

Academic Editor: Giovanni Conzo

J. Clin. Med. 2021, 10(15), 3407; https://doi.org/10.3390/jcm10153407

Received: 14 July 2021 / Revised: 28 July 2021 / Accepted: 29 July 2021 / Published: 30 July 2021

(This article belongs to the Special Issue Outcomes and Therapeutic Management of Thyroid Carcinoma)

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Abstract

Lymph node neck metastases are frequent in papillary thyroid carcinoma (PTC). Current guidelines state, on a weak level of evidence, that level VI dissection is mandatory in the presence of latero-cervical metastases. The aim of our study is to evaluate predictive factors for the absence of level VI involvement despite the presence of metastases to the lateral cervical stations in PTC. Eighty-eight patients operated for PTC with level II–V metastases were retrospectively enrolled in the study. Demographics, thyroid function, autoimmunity, nodule size and site, cancer variant, multifocality, Bethesda and EU-TIRADS, number of central and lateral lymph nodes removed, number of positive lymph nodes and outcome were recorded. At univariate analysis, PTC location and number of positive lateral lymph nodes were risk criteria for failure to cure. ROC curves demonstrated the association of the number of positive lateral lymph nodes and failure to cure. On multivariate analysis, the protective factors were PTC located in lobe center and number of positive lateral lymph nodes < 4. Kaplan–Meier curves confirmed the absence of central lymph nodes as a positive prognostic factor. In the selected cases, Central Neck Dissection (CND) could be avoided even in the presence of positive Lateralcervical Lymph Nodes (LLN+). View Full-Text

Keywords: papillary thyroid carcinoma; central compartment; lateralcervical lymph nodes; EU-TIRADS; Bethesda; central neck dissection; lateral neck dissection; skip metastasis

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MDPI and ACS Style

Graceffa, G.; Orlando, G.; Cocorullo, G.; Mazzola, S.; Vitale, I.; Proclamà, M.P.; Amato, C.; Saputo, F.; Rollo, E.M.; Corigliano, A.; Melfa, G.; Cipolla, C.; Scerrino, G. Predictors of Central Compartment Involvement in Patients with Positive Lateral Cervical Lymph Nodes According to Clinical and/or Ultrasound Evaluation. J. Clin. Med. 2021, 10, 3407. https://doi.org/10.3390/jcm10153407

AMA Style

Graceffa G, Orlando G, Cocorullo G, Mazzola S, Vitale I, Proclamà MP, Amato C, Saputo F, Rollo EM, Corigliano A, Melfa G, Cipolla C, Scerrino G. Predictors of Central Compartment Involvement in Patients with Positive Lateral Cervical Lymph Nodes According to Clinical and/or Ultrasound Evaluation. Journal of Clinical Medicine. 2021; 10(15):3407. https://doi.org/10.3390/jcm10153407

Chicago/Turabian Style

Graceffa, Giuseppa, Giuseppina Orlando, Gianfranco Cocorullo, Sergio Mazzola, Irene Vitale, Maria P. Proclamà, Calogera Amato, Federica Saputo, Enza M. Rollo, Alessandro Corigliano, Giuseppina Melfa, Calogero Cipolla, and Gregorio Scerrino. 2021. "Predictors of Central Compartment Involvement in Patients with Positive Lateral Cervical Lymph Nodes According to Clinical and/or Ultrasound Evaluation" Journal of Clinical Medicine 10, no. 15: 3407. https://doi.org/10.3390/jcm10153407

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Predictors of Central Compartment Involvement in Patients with Positive Lateral Cervical Lymph Nodes According to Clinical and/or Ultrasound Evaluation

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