Skip metastasis in papillary thyroid carcinoma is difficult to predict in clinical practice

BMC Cancer

Research Article

Zhou Tan¹  Xilin Nie¹  Minghua Ge¹ 

[1] Department of Head and Neck Surgery, Zhejiang Cancer Hospital, No.1 East Banshan Road, 310022, Hangzhou, People’s Republic of China;

关键词: Papillary thyroid carcinoma;    Skip metastasis;    Lateral lymph node metastasis;    Central lymph node metastasis;    Risk factors;   

DOI  :  10.1186/s12885-017-3698-2

 received in 2016-09-28, accepted in 2017-10-19,  发布年份 2017

来源: Springer

【 摘 要 】

BackgroundCervical lymph node metastases are very common in papillary thyroid cancer (PTC), and typically spread in a predictable stepwise fashion in clinical practice. However, lateral lymph node metastasis (LLNM) without central lymph node metastasis (CLNM) as skip metastasis is not rare in PTC. The aim of this study was to investigate the incidence, risk factors and pattern of skip metastasis in PTC.MethodsA total of 271 patients with PTC and suspicious LLN diagnosed by pre-operation examinations who underwent total thyroidectomy and central lymph node dissection plus lateral lymph node dissection between January 2008 and December 2011 were enrolled in this study. Clinicopathological features were collected, and the pattern of cervical lymph node metastasis and skip metastasis were analyzed.ResultsThe LLNM rate was 74.9% (203/271, diagnosed by postoperative pathology examination) and significantly associated with extrathyroid extension (ETE), primary tumor located at the upper pole, and CLNM (p < 0.05). The skip metastasis rate was 14.8% (30/203) and was more frequently found in microcarcinoma patients, especially when the primary tumor size was ≤0.5 cm (p = 0.001 OR = 12.9). However, skip metastasis was unrelated to the remaining factors examined.ConclusionSmall cancers with a pre-operation diagnosis of LLNM are more likely to have skip metastases, especially when the primary tumor size is less than 0.5 cm in diameter; however, this type of metastasis appears to develop in a random fashion. Thus, additional research is needed to identify potential predictive factors, such as a primary tumor located at the upper pole.

【 授权许可】

CC BY   
© The Author(s). 2017