A Prediction Model for Contralateral Central Neck Lymph Node Metastases in Unilateral Papillary Thyroid Cancer
The health problems caused by the frequent relapse of papillary thyroid carcinoma (PTC) remain a worldwide concern since the morbidity rate of PTC ranks the highest among thyroid cancers. Residues from contralateral central lymph node metastases (con-CLNM) are the key reason for persistence or recur...
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Wiley
2021-01-01
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| Series: | International Journal of Endocrinology |
| Online Access: | http://dx.doi.org/10.1155/2021/6621067 |
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| author | Hai-Long Tan Bo-Qiang Huang Gui-You Li Bo Wei Pei Chen Hui-Yu Hu Mian Liu Deng-Jie Ou-Yang Qiong Yang Zi-En Qin Qi-Man Shi Ning Li Peng Huang Shi Chang |
| author_facet | Hai-Long Tan Bo-Qiang Huang Gui-You Li Bo Wei Pei Chen Hui-Yu Hu Mian Liu Deng-Jie Ou-Yang Qiong Yang Zi-En Qin Qi-Man Shi Ning Li Peng Huang Shi Chang |
| author_sort | Hai-Long Tan |
| collection | DOAJ |
| description | The health problems caused by the frequent relapse of papillary thyroid carcinoma (PTC) remain a worldwide concern since the morbidity rate of PTC ranks the highest among thyroid cancers. Residues from contralateral central lymph node metastases (con-CLNM) are the key reason for persistence or recurrence of unilateral papillary thyroid carcinoma (uni-PTC); however, the ability to assess the status of con-CLNM in uni-PTC patients is limited. To clarify the risk factors of con-CLNM, a total of 250 patients with uni-PTC who underwent total thyroidectomy and bilateral central lymph node dissection were recruited in this study. We compared the clinical, sonographic, and pathological characteristics of patients with con-CLNM to those without con-CLNM and established a nomogram for con-CLNM in uni-PTC. We found that male sex, without Hashimoto’s thyroiditis, present capsular invasion, with ipsilateral lateral lymph node metastases, and the ratio of ipsilateral central lymph node metastases ≥0.16 were independent con-CLNM predictors of uni-PTC (ORs: 2.797, 0.430, 2.538, 2.202, and 26.588; 95% CIs: 1.182–6.617, 0.211–0.876, 1.223–5.267, 1.064–4.557, and 7.596–93.069, respectively). Additionally, a preoperative nomogram for the prediction of con-CLNM based on these risk factors showed good discrimination (C-index 0.881; 95% CI: 0.840–0.923; sensitivity 85.3%; specificity 76.0%) and good agreement via the calibration plot. Our study provided a way to quantitatively and accurately predict whether con-CLNM occurred in patients with uni-PTC, which may guide surgeons to evaluate the nodal status and perform tailored therapeutic central lymph node dissection. |
| format | Article |
| id | doaj-art-be14ff7334b344d9948bb073f76abfca |
| institution | DOAJ |
| issn | 1687-8337 1687-8345 |
| language | English |
| publishDate | 2021-01-01 |
| publisher | Wiley |
| record_format | Article |
| series | International Journal of Endocrinology |
| spelling | doaj-art-be14ff7334b344d9948bb073f76abfca2025-08-20T03:23:31ZengWileyInternational Journal of Endocrinology1687-83371687-83452021-01-01202110.1155/2021/66210676621067A Prediction Model for Contralateral Central Neck Lymph Node Metastases in Unilateral Papillary Thyroid CancerHai-Long Tan0Bo-Qiang Huang1Gui-You Li2Bo Wei3Pei Chen4Hui-Yu Hu5Mian Liu6Deng-Jie Ou-Yang7Qiong Yang8Zi-En Qin9Qi-Man Shi10Ning Li11Peng Huang12Shi Chang13Department of General Surgery, Xiangya Hospital Central South University, Changsha 410008, Hunan, ChinaDepartment of General Surgery, Xiangya Hospital Central South University, Changsha 410008, Hunan, ChinaDepartment of General Surgery, Xiangya Hospital Central South University, Changsha 410008, Hunan, ChinaDepartment of General Surgery, Xiangya Hospital Central South University, Changsha 410008, Hunan, ChinaDepartment of General Surgery, Xiangya Hospital Central South University, Changsha 410008, Hunan, ChinaDepartment of General Surgery, Xiangya Hospital Central South University, Changsha 410008, Hunan, ChinaDepartment of General Surgery, Xiangya Hospital Central South University, Changsha 410008, Hunan, ChinaDepartment of General Surgery, Xiangya Hospital Central South University, Changsha 410008, Hunan, ChinaDepartment of General Surgery, Xiangya Hospital Central South University, Changsha 410008, Hunan, ChinaDepartment of General Surgery, Xiangya Hospital Central South University, Changsha 410008, Hunan, ChinaDepartment of General Surgery, Xiangya Hospital Central South University, Changsha 410008, Hunan, ChinaDepartment of General Surgery, Xiangya Hospital Central South University, Changsha 410008, Hunan, ChinaDepartment of General Surgery, Xiangya Hospital Central South University, Changsha 410008, Hunan, ChinaDepartment of General Surgery, Xiangya Hospital Central South University, Changsha 410008, Hunan, ChinaThe health problems caused by the frequent relapse of papillary thyroid carcinoma (PTC) remain a worldwide concern since the morbidity rate of PTC ranks the highest among thyroid cancers. Residues from contralateral central lymph node metastases (con-CLNM) are the key reason for persistence or recurrence of unilateral papillary thyroid carcinoma (uni-PTC); however, the ability to assess the status of con-CLNM in uni-PTC patients is limited. To clarify the risk factors of con-CLNM, a total of 250 patients with uni-PTC who underwent total thyroidectomy and bilateral central lymph node dissection were recruited in this study. We compared the clinical, sonographic, and pathological characteristics of patients with con-CLNM to those without con-CLNM and established a nomogram for con-CLNM in uni-PTC. We found that male sex, without Hashimoto’s thyroiditis, present capsular invasion, with ipsilateral lateral lymph node metastases, and the ratio of ipsilateral central lymph node metastases ≥0.16 were independent con-CLNM predictors of uni-PTC (ORs: 2.797, 0.430, 2.538, 2.202, and 26.588; 95% CIs: 1.182–6.617, 0.211–0.876, 1.223–5.267, 1.064–4.557, and 7.596–93.069, respectively). Additionally, a preoperative nomogram for the prediction of con-CLNM based on these risk factors showed good discrimination (C-index 0.881; 95% CI: 0.840–0.923; sensitivity 85.3%; specificity 76.0%) and good agreement via the calibration plot. Our study provided a way to quantitatively and accurately predict whether con-CLNM occurred in patients with uni-PTC, which may guide surgeons to evaluate the nodal status and perform tailored therapeutic central lymph node dissection.http://dx.doi.org/10.1155/2021/6621067 |
| spellingShingle | Hai-Long Tan Bo-Qiang Huang Gui-You Li Bo Wei Pei Chen Hui-Yu Hu Mian Liu Deng-Jie Ou-Yang Qiong Yang Zi-En Qin Qi-Man Shi Ning Li Peng Huang Shi Chang A Prediction Model for Contralateral Central Neck Lymph Node Metastases in Unilateral Papillary Thyroid Cancer International Journal of Endocrinology |
| title | A Prediction Model for Contralateral Central Neck Lymph Node Metastases in Unilateral Papillary Thyroid Cancer |
| title_full | A Prediction Model for Contralateral Central Neck Lymph Node Metastases in Unilateral Papillary Thyroid Cancer |
| title_fullStr | A Prediction Model for Contralateral Central Neck Lymph Node Metastases in Unilateral Papillary Thyroid Cancer |
| title_full_unstemmed | A Prediction Model for Contralateral Central Neck Lymph Node Metastases in Unilateral Papillary Thyroid Cancer |
| title_short | A Prediction Model for Contralateral Central Neck Lymph Node Metastases in Unilateral Papillary Thyroid Cancer |
| title_sort | prediction model for contralateral central neck lymph node metastases in unilateral papillary thyroid cancer |
| url | http://dx.doi.org/10.1155/2021/6621067 |
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