Clinical outcomes in older or younger patients with papillary thyroid carcinoma: Impact of lymphadenopathy and patient age

Abstract Aims To examine lymph node metastasis (LNM) from papillary thyroid carcinoma (PTC) according to clinicopathological features and outcomes associated with the nodal status. Methods We reviewed 231 patients with PTC (≥1.0 cm) who underwent initial thyroidectomy with modified neck dissection....

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Published inEuropean journal of surgical oncology Vol. 34; no. 2; pp. 202 - 207
Main Authors Wada, N, Masudo, K, Nakayama, H, Suganuma, N, Matsuzu, K, Hirakawa, S, Rino, Y, Masuda, M, Imada, T
Format Journal Article
LanguageEnglish
Published England Elsevier Ltd 01.02.2008
Subjects
Adolescent
Adult
Age Distribution
Aged
Aged, 80 and over
Carcinoma, Papillary - mortality
Carcinoma, Papillary - secondary
Carcinoma, Papillary - surgery
Cohort Studies
Disease-Free Survival
Female
Hematology, Oncology and Palliative Medicine
Humans
Immunohistochemistry
Incidence
Lymph Node Excision - methods
Lymph node metastasis
Lymph Nodes - pathology
Lymphadenopathy
Lymphatic Metastasis
Male
Middle Aged
Multivariate Analysis
Neck Dissection - methods
Neoplasm Recurrence, Local - epidemiology
Neoplasm Recurrence, Local - pathology
Neoplasm Staging
Older patients
Papillary thyroid carcinoma
Prognosis
Proportional Hazards Models
Recurrence
Retrospective Studies
Risk Assessment
Sex Distribution
Statistics, Nonparametric
Surgery
Survival Analysis
Thyroid Neoplasms - mortality
Thyroid Neoplasms - pathology
Thyroid Neoplasms - surgery
Thyroidectomy - methods
Lymph node metastasis
Older patients
Lymphadenopathy
Recurrence
Papillary thyroid carcinoma
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Abstract Abstract Aims To examine lymph node metastasis (LNM) from papillary thyroid carcinoma (PTC) according to clinicopathological features and outcomes associated with the nodal status. Methods We reviewed 231 patients with PTC (≥1.0 cm) who underwent initial thyroidectomy with modified neck dissection. LNM was examined in the central and lateral compartment and risk factors for disease-free survival (DFS) were evaluated. Nodal status and outcomes were further evaluated in four subgroups, 19 older patients (≥45 years old) with palpable lymphadenopathy (PLA) and 134 without PLA, and 11 younger patients (<45 years old) with PLA and 67 without PLA, because multivariate analysis revealed that age ( p < 0.05, Hazard ratio (HR) 3.51) and PLA ( p < 0.0001, HR 14.9) were risk factors for DFS. Results Central and lateral LNM were found in 176 and 151 patients. Seventeen exhibited skip metastasis. Recurrence and disease death occurred in 23 and 5. In analysis of the four subgroups, recurrence was significantly frequent in older patients with PLA than in younger patients with PLA or older patients without PLA (8/19 vs. 3/11 or 12/134). Younger patients without PLA did not exhibit recurrence. Conclusions Prognosis is worse in older patients with PLA. Such patients should be treated carefully with a considerable treatment strategy.
AbstractList Abstract Aims To examine lymph node metastasis (LNM) from papillary thyroid carcinoma (PTC) according to clinicopathological features and outcomes associated with the nodal status. Methods We reviewed 231 patients with PTC (≥1.0 cm) who underwent initial thyroidectomy with modified neck dissection. LNM was examined in the central and lateral compartment and risk factors for disease-free survival (DFS) were evaluated. Nodal status and outcomes were further evaluated in four subgroups, 19 older patients (≥45 years old) with palpable lymphadenopathy (PLA) and 134 without PLA, and 11 younger patients (<45 years old) with PLA and 67 without PLA, because multivariate analysis revealed that age ( p < 0.05, Hazard ratio (HR) 3.51) and PLA ( p < 0.0001, HR 14.9) were risk factors for DFS. Results Central and lateral LNM were found in 176 and 151 patients. Seventeen exhibited skip metastasis. Recurrence and disease death occurred in 23 and 5. In analysis of the four subgroups, recurrence was significantly frequent in older patients with PLA than in younger patients with PLA or older patients without PLA (8/19 vs. 3/11 or 12/134). Younger patients without PLA did not exhibit recurrence. Conclusions Prognosis is worse in older patients with PLA. Such patients should be treated carefully with a considerable treatment strategy.
To examine lymph node metastasis (LNM) from papillary thyroid carcinoma (PTC) according to clinicopathological features and outcomes associated with the nodal status. We reviewed 231 patients with PTC (≥1.0 cm) who underwent initial thyroidectomy with modified neck dissection. LNM was examined in the central and lateral compartment and risk factors for disease-free survival (DFS) were evaluated. Nodal status and outcomes were further evaluated in four subgroups, 19 older patients (≥45 years old) with palpable lymphadenopathy (PLA) and 134 without PLA, and 11 younger patients (<45 years old) with PLA and 67 without PLA, because multivariate analysis revealed that age ( p < 0.05, Hazard ratio (HR) 3.51) and PLA ( p < 0.0001, HR 14.9) were risk factors for DFS. Central and lateral LNM were found in 176 and 151 patients. Seventeen exhibited skip metastasis. Recurrence and disease death occurred in 23 and 5. In analysis of the four subgroups, recurrence was significantly frequent in older patients with PLA than in younger patients with PLA or older patients without PLA (8/19 vs. 3/11 or 12/134). Younger patients without PLA did not exhibit recurrence. Prognosis is worse in older patients with PLA. Such patients should be treated carefully with a considerable treatment strategy.
AIMSTo examine lymph node metastasis (LNM) from papillary thyroid carcinoma (PTC) according to clinicopathological features and outcomes associated with the nodal status.METHODSWe reviewed 231 patients with PTC (> or =1.0cm) who underwent initial thyroidectomy with modified neck dissection. LNM was examined in the central and lateral compartment and risk factors for disease-free survival (DFS) were evaluated. Nodal status and outcomes were further evaluated in four subgroups, 19 older patients (> or =45years old) with palpable lymphadenopathy (PLA) and 134 without PLA, and 11 younger patients (<45years old) with PLA and 67 without PLA, because multivariate analysis revealed that age (p<0.05, Hazard ratio (HR) 3.51) and PLA (p<0.0001, HR 14.9) were risk factors for DFS.RESULTSCentral and lateral LNM were found in 176 and 151 patients. Seventeen exhibited skip metastasis. Recurrence and disease death occurred in 23 and 5. In analysis of the four subgroups, recurrence was significantly frequent in older patients with PLA than in younger patients with PLA or older patients without PLA (8/19 vs. 3/11 or 12/134). Younger patients without PLA did not exhibit recurrence.CONCLUSIONSPrognosis is worse in older patients with PLA. Such patients should be treated carefully with a considerable treatment strategy.
To examine lymph node metastasis (LNM) from papillary thyroid carcinoma (PTC) according to clinicopathological features and outcomes associated with the nodal status. We reviewed 231 patients with PTC (> or =1.0cm) who underwent initial thyroidectomy with modified neck dissection. LNM was examined in the central and lateral compartment and risk factors for disease-free survival (DFS) were evaluated. Nodal status and outcomes were further evaluated in four subgroups, 19 older patients (> or =45years old) with palpable lymphadenopathy (PLA) and 134 without PLA, and 11 younger patients (<45years old) with PLA and 67 without PLA, because multivariate analysis revealed that age (p<0.05, Hazard ratio (HR) 3.51) and PLA (p<0.0001, HR 14.9) were risk factors for DFS. Central and lateral LNM were found in 176 and 151 patients. Seventeen exhibited skip metastasis. Recurrence and disease death occurred in 23 and 5. In analysis of the four subgroups, recurrence was significantly frequent in older patients with PLA than in younger patients with PLA or older patients without PLA (8/19 vs. 3/11 or 12/134). Younger patients without PLA did not exhibit recurrence. Prognosis is worse in older patients with PLA. Such patients should be treated carefully with a considerable treatment strategy.
Author Rino, Y
Wada, N
Suganuma, N
Matsuzu, K
Imada, T
Hirakawa, S
Masudo, K
Nakayama, H
Masuda, M
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Keywords Lymph node metastasis
Older patients
Lymphadenopathy
Recurrence
Papillary thyroid carcinoma
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Snippet Abstract Aims To examine lymph node metastasis (LNM) from papillary thyroid carcinoma (PTC) according to clinicopathological features and outcomes associated...
To examine lymph node metastasis (LNM) from papillary thyroid carcinoma (PTC) according to clinicopathological features and outcomes associated with the nodal...
AIMSTo examine lymph node metastasis (LNM) from papillary thyroid carcinoma (PTC) according to clinicopathological features and outcomes associated with the...
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StartPage 202
SubjectTerms Adolescent
Adult
Age Distribution
Aged
Aged, 80 and over
Carcinoma, Papillary - mortality
Carcinoma, Papillary - secondary
Carcinoma, Papillary - surgery
Cohort Studies
Disease-Free Survival
Female
Hematology, Oncology and Palliative Medicine
Humans
Immunohistochemistry
Incidence
Lymph Node Excision - methods
Lymph node metastasis
Lymph Nodes - pathology
Lymphadenopathy
Lymphatic Metastasis
Male
Middle Aged
Multivariate Analysis
Neck Dissection - methods
Neoplasm Recurrence, Local - epidemiology
Neoplasm Recurrence, Local - pathology
Neoplasm Staging
Older patients
Papillary thyroid carcinoma
Prognosis
Proportional Hazards Models
Recurrence
Retrospective Studies
Risk Assessment
Sex Distribution
Statistics, Nonparametric
Surgery
Survival Analysis
Thyroid Neoplasms - mortality
Thyroid Neoplasms - pathology
Thyroid Neoplasms - surgery
Thyroidectomy - methods
Title Clinical outcomes in older or younger patients with papillary thyroid carcinoma: Impact of lymphadenopathy and patient age
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https://dx.doi.org/10.1016/j.ejso.2007.10.001
https://www.ncbi.nlm.nih.gov/pubmed/18023321
https://search.proquest.com/docview/70212507
Volume 34
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