Number of tumor foci as predictor of lateral lymph node metastasis in papillary thyroid carcinoma

Head Neck. 2015 May;37(5):650-4. doi: 10.1002/hed.23650. Epub 2014 Apr 10.

Abstract

Background: The purpose of this study was to determine the clinicopathologic characteristics of patients with papillary thyroid carcinoma (PTC) by the number of tumor foci.

Methods: A retrospective analysis of 2095 patients with PTC was performed. The study population was divided into 4 groups based on the number of tumor foci: N1 (1 tumor focus), N2 (2 foci), N3 (3 foci), and N4 (4 or more foci).

Results: An increasing number of tumor foci was significantly associated with older age at diagnosis (p = .006), cervical lymph node metastasis (p < .001), and advanced TNM stage of disease (p = .001) at initial surgery. The multivariate adjusted odds ratios (ORs) and 95% confidence intervals (95% CIs) for the N2, N3, and N4 groups compared to the N1 group for lateral lymph node metastasis were OR 1.53 (95% CI, 1.05-2.22), OR 2.57 (95% CI, 1.50-4.42), and OR 2.88 (95% CI, 1.42-5.84), respectively.

Conclusion: An increase in the number of tumor foci was strongly associated with older age at diagnosis, cervical lymph node metastasis, and advanced TNM stage of PTC. The number of tumor foci independently predicted lateral lymph node metastasis.

Keywords: lymph node metastasis; multifocality; papillary thyroid carcinoma.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • Aged
  • Biopsy, Needle
  • Carcinoma / mortality
  • Carcinoma / secondary*
  • Carcinoma / surgery
  • Carcinoma, Papillary
  • Cohort Studies
  • Confidence Intervals
  • Disease-Free Survival
  • Female
  • Humans
  • Immunohistochemistry
  • Lymph Node Excision / methods
  • Lymph Nodes / pathology*
  • Lymph Nodes / surgery
  • Lymphatic Metastasis
  • Male
  • Middle Aged
  • Multivariate Analysis
  • Neoplasm Invasiveness / pathology
  • Neoplasm Recurrence, Local / mortality
  • Neoplasm Recurrence, Local / pathology*
  • Neoplasm Staging
  • Prognosis
  • Retrospective Studies
  • Risk Assessment
  • Survival Analysis
  • Thyroid Cancer, Papillary
  • Thyroid Neoplasms / mortality
  • Thyroid Neoplasms / pathology*
  • Thyroid Neoplasms / secondary
  • Thyroid Neoplasms / surgery
  • Thyroidectomy / methods*
  • Young Adult