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Trends of the prevalence rate of central lymph node metastasis and multifocality in patients with low-risk papillary thyroid carcinoma after delayed thyroid surgery.
Wang, Pei; Dong, Zhizhong; Zhao, Shuyan; Su, Yanjun; Zhang, Jianming; Ma, Yunhai; Diao, Chang; Qian, Jun; Cheng, Ruochuan; Liu, Wen.
Afiliação
  • Wang P; Department of Radiation Oncology, Cancer Institute, The First Affiliated Hospital, and College of Clinical Medicine of Henan University of Science and Technology, Luoyang, China.
  • Dong Z; Department of Medical Imaging, The First Affiliated Hospital of Kunming Medical University, Kunming, China.
  • Zhao S; Department of Thyroid Surgery, Clinical Research Center for Thyroid Disease of Yunnan Province, The First Affiliated Hospital of Kunming Medical University, Kunming, China.
  • Su Y; Department of Thyroid Surgery, Clinical Research Center for Thyroid Disease of Yunnan Province, The First Affiliated Hospital of Kunming Medical University, Kunming, China.
  • Zhang J; Department of Thyroid Surgery, Clinical Research Center for Thyroid Disease of Yunnan Province, The First Affiliated Hospital of Kunming Medical University, Kunming, China.
  • Ma Y; Department of Thyroid Surgery, Clinical Research Center for Thyroid Disease of Yunnan Province, The First Affiliated Hospital of Kunming Medical University, Kunming, China.
  • Diao C; Department of Thyroid Surgery, Clinical Research Center for Thyroid Disease of Yunnan Province, The First Affiliated Hospital of Kunming Medical University, Kunming, China.
  • Qian J; Department of Thyroid Surgery, Clinical Research Center for Thyroid Disease of Yunnan Province, The First Affiliated Hospital of Kunming Medical University, Kunming, China.
  • Cheng R; Department of Thyroid Surgery, Clinical Research Center for Thyroid Disease of Yunnan Province, The First Affiliated Hospital of Kunming Medical University, Kunming, China.
  • Liu W; Department of Thyroid Surgery, Clinical Research Center for Thyroid Disease of Yunnan Province, The First Affiliated Hospital of Kunming Medical University, Kunming, China.
Front Endocrinol (Lausanne) ; 15: 1349272, 2024.
Article em En | MEDLINE | ID: mdl-38638135
ABSTRACT

Background:

Active surveillance has been an option for patients with low-risk papillary thyroid carcinoma (PTC). However, whether delayed surgery leads to an increased risk of local tumor metastasis remain unclear. We sought to investigate the impact of observation time on central lymph node metastasis (CLNM) and multifocal disease in patients with low-risk PTC.

Methods:

Patients who were diagnosed with asymptomatic low-risk PTC, and with a pathological maximum tumor size ≤1.5 cm by were included. The patients were classified into observation group and immediate surgery group, and subgroup analyses were conducted by observation time period. The prevalence of CLNM, lymph node (LN) involved >5, multifocal PTC and bilateral multifocal PTC were considered as outcome variables. The changing trend and risk ratio of prevalence over observation time were evaluated by Mann-Kendall trend test and Logistics regression.

Results:

Overall, 3,427 and 1,860 patients were classified to the observation group and immediate surgery group, respectively. Trend tests showed that decreasing trends both on the prevalence of CLNM and LN involved >5 over the observation time, but the difference was not statistically significant, and the prevalence of multifocal PTC and bilateral multifocal PTC showed the significant decreasing trends. After adjustment, multivariate analysis showed no statistically significant difference between observed and immediate surgery groups in the four outcome variables.

Conclusion:

In patients with subclinical asymptomatic low-risk PTC, observation did not result in an increased incidence of local metastatic disease, nor did the increased surgery extent in patients with delayed surgery compared to immediate surgery. These findings can strengthen the confidence in the active surveillance management for both doctors and patients.
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Texto completo: 1 Coleções: 01-internacional Base de dados: MEDLINE Assunto principal: Neoplasias da Glândula Tireoide / Carcinoma Papilar Limite: Humans Idioma: En Revista: Front Endocrinol (Lausanne) Ano de publicação: 2024 Tipo de documento: Article País de afiliação: China

Texto completo: 1 Coleções: 01-internacional Base de dados: MEDLINE Assunto principal: Neoplasias da Glândula Tireoide / Carcinoma Papilar Limite: Humans Idioma: En Revista: Front Endocrinol (Lausanne) Ano de publicação: 2024 Tipo de documento: Article País de afiliação: China