Prognostic implications of lymph node yield in pediatric patients with N1b papillary thyroid cancer

IF 5.4 3区材料科学 Q2 CHEMISTRY, PHYSICAL

ACS Applied Energy Materials Pub Date : 2024-08-21 DOI:10.1016/j.oraloncology.2024.106984

Yizhuo Wei , Liu Xiao , Lina Liu , Lei Shi , Yu Wang , Bin Liu

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引用次数: 0

Abstract

Objective

To investigate whether lymph node (LN) yield influences clinical outcomes for pediatric patients with laterocervical lymph node metastasis (N1b) from papillary thyroid cancer (PTC).

Methods

Conducted from January 1, 2008, to December 31, 2022, this was a cohort study of pediatric patients (aged ≤ 18 years) with N1b PTC who underwent total thyroidectomy and therapeutic LN dissection in the central and lateral compartments at 3 hospitals in southwest China in 2008–2021, with follow-up until 2022. Patients with distant metastasis were excluded. Univariate and multivariate Cox proportional hazards regression analyses were used to identify factors associated with persistent/recurrent diseases.

Results

A total of 102 pediatric patients (median [range] age, 16 [6–18] years) were analyzed: 36 patients (35 %) with T1; 27 patients (26 %), T2; 18 patients (18 %), T3; and 21 patients (21 %), T4. During a median follow-up of 50 months (range, 12–154 months), persistent diseases occurred in 40 (39 %) patients. Receiver operating characteristic analysis identified LN yield cut‐off (<42 LNs) to predict persistent diseases. Multivariate analysis revealed that a less-extensive lymphadenectomy (<42 LNs) was an independent risk factor for persistent diseases (hazard ratio, 2.4; 95 % confidence intervals, 1.09–5.29; P=.029).

Conclusions

Our study highlights that a higher LN yield may favorably influence prognosis in pediatric patients with N1b PTC.

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N1b甲状腺乳头状癌儿科患者淋巴结转移率的预后影响

目的探讨淋巴结（LN）产量是否会影响甲状腺乳头状癌（PTC）晚期颈淋巴结转移（N1b）的儿科患者的临床预后。方法2008年1月1日至2022年12月31日，西南地区3家医院对2008-2021年期间接受甲状腺全切除术和中央及外侧治疗性淋巴结清扫术的N1b PTC儿童患者（年龄小于18岁）进行队列研究，随访至2022年。排除了远处转移的患者。结果共分析了102例儿科患者（中位数[范围]年龄为16[6-18]岁）：T1患者36例（35%）；T2患者27例（26%）；T3患者18例（18%）；T4患者21例（21%）。在中位 50 个月（12-154 个月）的随访期间，40 名患者（39%）出现了顽固性疾病。接收者操作特征分析确定了预测持续性疾病的 LN 产量临界值（42 LN）。多变量分析显示，范围较小的淋巴结切除术（42 LNs）是疾病持续存在的独立风险因素（危险比，2.4；95 % 置信区间，1.09-5.29；P=.029）。

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来源期刊

ACS Applied Energy Materials Materials Science-Materials Chemistry

CiteScore

10.30

自引率

6.20%

发文量

1368

期刊介绍： ACS Applied Energy Materials is an interdisciplinary journal publishing original research covering all aspects of materials, engineering, chemistry, physics and biology relevant to energy conversion and storage. The journal is devoted to reports of new and original experimental and theoretical research of an applied nature that integrate knowledge in the areas of materials, engineering, physics, bioscience, and chemistry into important energy applications.