Risk factors for cervical lymph node metastasis in the central or lateral cervical region in medullary thyroid carcinoma: a systematic review and meta-analysis.
Eur Arch Otorhinolaryngol
; 281(2): 547-561, 2024 Feb.
Article
em En
| MEDLINE
| ID: mdl-37801162
ABSTRACT
PURPOSE:
Compared with other types of thyroid carcinoma, patients with medullary thyroid carcinoma (MTC) are more likely to develop cervical lymph node metastasis. This study was conducted to clarify the risk factors for cervical lymph node metastasis (central lymph node metastasis or lateral cervical lymph node metastasis) in MTC by meta-analysis, and to provide evidence-based basis for the treatment and prognosis of MTC.METHODS:
The literatures related to cervical lymph node metastasis in medullary thyroid carcinoma were searched in PubMed, Embase, Web of Science, Cochrane, CNKI and Wanfang databases, and statistical analysis was performed using Revman 5.3 and Stata 14.0 software.RESULTS:
A total of 28 papers were included in this paper, and meta-analysis showed that the occurrence of central lymph node metastasis (CLNM) in MTC patients was significantly associated with tumor size (OR = 3.07, 95%CI 2.04-4.63, P < 0.00001), multifocality (OR = 0.29, 95%CI 0.19-0.44, P < 0.00001), bilaterality (OR = 3.75, 95% CI 1.95-7.14, P < 0.0001), capsular invasion (OR = 9.88, 95% CI 5.93-16.45, P < 0.00001) and extrathyroidal extension (OR = 5.48, 95% CI 2.61-11.51, P < 0.00001). While the occurrence of lateral cervical lymph node metastasis (LLNM) in MTC patients was strongly correlated with gender (OR = 2.97, 95%CI 2.46-3.58, P < 0.00001), tumor size (OR = 3.88, 95%CI 1.90-7.92, P = 0.0002 < 0.05), multifocality (OR = 0.43, 95%CI 0.35-0.51, P < 0.00001), bilaterality (OR = 2.93, 95% CI 1.72-4.98, P < 0.0001), capsular invasion (OR = 8.44, 95% CI 6.11-11.64, P < 0.00001), extrathyroidal extension (OR = 7.04, 95% CI 5.54-8.94, P < 0.00001), margin of the tumor (OR = 4.47, 95% CI 2.37-8.44, P < 0.00001), shape of the tumor (OR = 6.81, 95% CI 3.64-12.73, P < 0.00001), preoperative calcitonin level (SMD = 1.39, 95% CI 0.98-1.80, P < 0.00001), preoperative carcinoembryonic antigen level (SMD = 0.97, 95% CI 0.74-1.20, P < 0.00001) and CLNM (OR = 19.70, 95% CI 14.16-27.43, P < 0.00001).CONCLUSION:
Tumor size, multifocality, bilaterality, capsular invasion and extrathyroidal extension are the main risk factors for developing CLNM in MTC patients; And risk factors for developing LLNM in MTC patients include gender, tumor size, multifocality, bilaterality, capsular invasion, extrathyroidal extension, margin of the tumor, shape of the tumor, preoperative calcitonin level, preoperative carcinoembryonic antigen level and central lymph node metastasis. These risk factors can guide the individualized treatment plan and improve the prognosis of MTC patients.Palavras-chave
Texto completo:
1
Coleções:
01-internacional
Base de dados:
MEDLINE
Assunto principal:
Calcitonina
/
Neoplasias da Glândula Tireoide
/
Carcinoma Neuroendócrino
Tipo de estudo:
Etiology_studies
/
Prognostic_studies
/
Risk_factors_studies
/
Systematic_reviews
Limite:
Humans
Idioma:
En
Revista:
Eur Arch Otorhinolaryngol
Ano de publicação:
2024
Tipo de documento:
Article