Intraglandular Dissemination Is a Risk Factor for Lymph Node Metastasis and Recurrence in Papillary Thyroid Carcinoma: A Propensity Score Matching Analysis.
Tiantian Yu, Zishuo Liu, Jingyu Ma, Peng Su, Xiaoyu Ji, Nan Liu, Changyuan Ding, Zhenpeng Yang, Weili Liang, Bin Lv
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引用次数: 0
Abstract
Background: Intraglandular dissemination (ID) is an important clinicopathological feature, but the statistical evidence of its relationship with lymph node metastasis (LNM) and the prognosis of papillary thyroid carcinoma (PTC) has not been widely reported in the literature. The purpose of this study was to investigate the potential correlation between ID, LNM, and prognosis in PTC patients.
Methods: Patients with PTC were retrospectively collected from Qilu Hospital of Shandong University from 2017 to 2019 and categorized into two groups based on postoperative routine pathology: intraglandular dissemination group (ID group) and the non-intraglandular dissemination group (NID group). The propensity score matching (PSM) was used to analyze and compare the differences in LNM and prognosis between groups.
Results: Among the 2845 patients included in the study, 6.85% had ID. After PSM matching, ID was associated with an increased risk of LNM (OR: 2.143, 95% CI: 1.279-3.591, p = 0.004) and recurrence in PTC patients (HR: 6.585, 95% CI: 1.782-24.335, p = 0.005). Kaplan-Meier curves showed that the recurrence-free survival (RFS) of the ID group before and after PSM was worse than that of the NID group (95.3% vs. 99.0%, p < 0.001; 95.0% vs. 99.0%, p = 0.011).
Conclusion: ID is an independent risk factor for LNM (includes microscopic metastasis) and postoperative recurrence in PTC patients. The recurrence rate of ID-PTC patients with markers of aggressive disease is higher than that of ID-PTC patients alone. Patients with ID-PTC require more intensive follow-up to monitor for recurrence. The necessity of more extensive lymph node dissection for these patients may need to be validated by future multi-center, prospective studies.
期刊介绍:
Head & Neck is an international multidisciplinary publication of original contributions concerning the diagnosis and management of diseases of the head and neck. This area involves the overlapping interests and expertise of several surgical and medical specialties, including general surgery, neurosurgery, otolaryngology, plastic surgery, oral surgery, dermatology, ophthalmology, pathology, radiotherapy, medical oncology, and the corresponding basic sciences.