scholarly journals Predictors of Regional Lymph Node Recurrence after Initial Thyroidectomy in Patients with Thyroid Cancer

2016 ◽  
Vol 2016 ◽  
pp. 1-5 ◽  
Author(s):  
Amirsina Sharifi ◽  
Abolfazl Shojaeifard ◽  
Ahmadreza Soroush ◽  
Mehdi Jafari ◽  
Ali Ghorbani Abdehgah ◽  
...  
Keyword(s):  
Risk Factors ◽  
Thyroid Cancer ◽  
Lymph Node ◽  
Tumor Size ◽  
Odds Ratio ◽  
Regional Lymph Node ◽  
Significant Risk ◽  
Cervical Lymphadenopathy ◽  
Male Gender ◽  
Lymph Node Recurrence

Background.Regional lymph node recurrence (RLNR) is common in patients with thyroid cancer but clinicopathological predictors are unclear. We aimed to clarify these predictors and identify patients who would benefit from prophylactic lymph node dissection the most.Method.343 patients with different types of thyroid cancer were analyzed retrospectively. All patients underwent total thyroidectomy between 2007 and 2013.Results.The median ± interquartile range of patients’ age was 40 ± 25 years. 245 (71.4%) patients were female. Regarding the risk of regional lymph node recurrence, we found that male gender, age ≥45 years, non-PTC (i.e., medullary, follicular, and anaplastic types) histopathology, T3 (i.e., tumor size >4 cm in the greatest dimension limited to the thyroid or any tumor with minimal extrathyroid extension), stage IVa, and isolated cervical lymphadenopathy as initial manifestation (ICL) are significant risk factors. T3 (p< 0.001; odds ratio = 156.41, 95% CI [55.72–439.1]) and ICL (p< 0.001; odds ratio = 77.79, 95% CI [31.55–191.81]) were the strongest predictors of regional lymph node recurrence.Conclusion.We found easily achievable risk factors for RLNR in thyroid cancers patients. We suggested that patients with specific clinicopathological features like male gender, age ≥45 years, larger tumor size, and extrathyroidal extension be considered as prophylactic lymphadenectomy candidates.

scholarly journals Identifying risk factors of lateral lymph node recurrence in clinically node-negative papillary thyroid cancer

Medicine ◽  
2018 ◽  
Vol 97 (51) ◽  
pp. e13435 ◽  
Author(s):  
Young Jae Ryu ◽  
Shin Jae Kang ◽  
Jin Seong Cho ◽  
Jung Han Yoon ◽  
Min Ho Park
Keyword(s):  
Risk Factors ◽  
Thyroid Cancer ◽  
Lymph Node ◽  
Papillary Thyroid Cancer ◽  
Papillary Thyroid ◽  
Lateral Lymph Node ◽  
Node Negative ◽  
Lymph Node Recurrence

Role of Lymph Node Dissection in Primary Surgery for Thyroid Cancer

2007 ◽  
Vol 5 (6) ◽  
pp. 623-630 ◽  
Author(s):  
Elizabeth G. Grubbs ◽  
Douglas B. Evans
Keyword(s):  
Thyroid Cancer ◽  
Lymph Node ◽  
Preoperative Evaluation ◽  
Significant Risk ◽  
Cervical Lymphadenopathy ◽  
Operative Management ◽  
Surgical Removal ◽  
Cervical Lymph Nodes ◽  
N0 Neck ◽  
Preoperative Ultrasound

The preoperative evaluation of the clinically N0 neck and the operative management of cervical lymph nodes in patients with papillary and medullary thyroid cancer remains controversial. The appreciation that even patients with low-risk disease have a significant risk for recurrence has generated interest in a more comprehensive preoperative evaluation of the neck and has renewed debate on the extent of lymphadenectomy at the time of thyroidectomy. The authors recommend using preoperative ultrasound before thyroidectomy for all patients with thyroid cancer and before any subsequent surgeries for recurrent disease to identify the extent of lymph node metastases and thereby facilitate complete surgical removal of all gross disease in the neck. The optimal surgical procedure for removing cervical lymphadenopathy is compartment-oriented neck dissection based on the findings from preoperative ultrasound.

scholarly journals Risk Factors for Tumor Size Increase During Active Surveillance of Papillary Thyroid Cancer: Meta-Analysis and Systematic Review

2021 ◽  
Vol 64 (12) ◽  
pp. 914-921
Author(s):  
Doh Young Lee ◽  
Pilkeun Jang
Keyword(s):  
Risk Factors ◽  
Systematic Review ◽  
Thyroid Cancer ◽  
Papillary Thyroid Cancer ◽  
Active Surveillance ◽  
Tumor Size ◽  
Odds Ratio ◽  
Meta Analysis ◽  
Size Increase ◽  
Papillary Thyroid

Background and Objectives The purpose of this study was to systematically review literatures on active surveillance for low-risk differentiated thyroid cancer, and to evaluate risk factors for tumor size increase during active surveillance.Subjects and Method We conducted a systematic review and a meta-analysis of studies reporting on tumor growth during active surveillance of papillary thyroid cancer. Using the MEDLINE and EMBASE databases, we searched studies published from the inception of database to December 2020. Studies were included if reported on at least one clinical risk parameter in addition to reporting on the change in tumor size during active surveillance.Results Out of 33 studies screened, seven were included in the meta-analysis. The odds ratio of a temporal size increase of more than 3 mm in papillary thyroid cancer was 0.011 person-years (95% confidence interval [CI]: 0.009 to 0.013). The odds ratio of lymph node metastasis was 0.002 person-years (95% CI: 0.001 to 0.003). Younger age was a significant risk factor for tumor growth during active surveillance, with a standardized median difference of -0.63 (95% CI: -1.00 to -0.27). In the three studies that evaluated the association of thyroid-stimulating hormone levels and tumor size, the results were contradictory.Conclusion Active surveillance may be used more cautiously for younger patients.

scholarly journals A Study on Central Lymph Node Metastasis in 543 cN0 Papillary Thyroid Carcinoma Patients

2016 ◽  
Vol 2016 ◽  
pp. 1-5 ◽  
Author(s):  
Huanhuan Yan ◽  
Xiaoqian Zhou ◽  
Hui Jin ◽  
Xiang Li ◽  
Miao Zheng ◽  
...  
Keyword(s):  
Risk Factors ◽  
Multivariate Analysis ◽  
Lymph Node ◽  
Papillary Thyroid Carcinoma ◽  
Tumor Size ◽  
Male Gender ◽  
Papillary Thyroid ◽  
Central Lymph Node ◽  
Node Metastasis ◽  
Central Lymph

Background. Papillary thyroid carcinoma (PTC) with central lymph node metastases (CLNMs) is common. The objective of this study was to investigate the incidence and risk factors of lymph node metastasis patients with PTC.Patients and Methods. Between January 2013 and February 2015, a retrospective study of 543 patients with PTC undergoing hemithyroidectomy or total thyroidectomy with routine central lymph node dissection (CLND) was analyzed. Clinicopathologic risk factors for CLNM were studied using univariate and multivariate analysis by SPSS 22.0 software.Results. The incidence of CLNMs in PTC patients was 38.1% (207/543). In the multivariate analysis, male gender (p<0.001, OR: 1.984), age <45 years (p<0.001, OR: 1.934), bilaterality (p=0.006, OR: 1.585), tumor size ≥0.25 cm (p=0.001, OR: 7.655), and external extension (p=0.001, OR: 7.579) were independent risk factors of CLNMs. Furthermore, in PTC patients with tumor size <0.25 cm, all 7 males and 21 patients with unilaterality were not found to have CLNMs.Conclusions. CLNMs are prevalent in the PTC patients with the following risk factors: male gender, age <45 years, bilaterality, tumor size ≥0.25 cm, and external extension. PTC patients with tumor size <0.25 cm, male patients, and patients with unilateral lesion could be considered safe from CLNMs.

EVALUATION OF CLINICAL AND PARACLINICAL FEATURES IN PATIENTS WITH CARCINOMA OF ORAL CAVITY

2016 ◽  
pp. 56-60
Author(s):  
Van Minh Nguyen ◽  
Hong Loi Nguyen ◽  
Thi Kim Anh Dang
Keyword(s):  
Lymph Node ◽  
Lymph Node Metastasis ◽  
Oral Cavity ◽  
Tumor Size ◽  
Regional Lymph Node ◽  
Regional Lymph Node Metastasis ◽  
Female Ratio ◽  
Histopathological Grade ◽  
Node Metastasis ◽  
Metastasis Rate

Background: To evaluate the clinical, hystopathologycal features and correlation between lymph node metastasis and hystopathologycal grade in patients with carcinoma of the oral cavity. Materials and Methods: From July 2015 to July 2016, 32 patients with carcinoma of the oral cavity at Hue Central Hospital Results: The most common age group from 51 to 60 years and the male/female ratio was 1.9/1. Tumor were usually observed around the the tongue (40.6%) and oral floor (34.4%). Most of the tumor size is larger than 2 cm diameters (> 80%). The regional lymph node metastasis rate was 43.8% and there was a positive correlation between lymph node metastasis and tumor size (p <0.05). Squamous-cell carcinoma was mainly type of histopathology. Difference between the rate of lymph node metastasis in patient groups with different histopathological grade show no statistical significance (p> 0.05). Conclusion: the greater tumor, the higher regional lymph node metastasis. There is no relationship between the lymph node metastasis rate and histopathological grade of oral carcinoma. Key words: : carcinoma of oral cavity, tumor size, lymph node metastasis, histopathology

Deep Spinal Infection after Outpatient Epidural Injections for Pain: A Retrospective Sample Cohort Study Using a Claims Database in South Korea

2021 ◽  
Author(s):  
Chang-Soon Lee ◽  
Young Jae Park ◽  
Jee Youn Moon ◽  
Yong-Chul Kim
Keyword(s):  
Risk Factors ◽  
South Korea ◽  
Odds Ratio ◽  
Multivariable Analysis ◽  
Significant Risk ◽  
Epidural Injection ◽  
Spinal Infection ◽  
Single Shot ◽  
Epidural Injections ◽  
Spinal Infections

Background Deep spinal infection is a devastating complication after epidural injection. This study aimed to investigate the incidence of deep spinal infection primarily after outpatient single-shot epidural injection for pain. Secondarily, this study assessed the national trends of the procedure and risk factors for said infection. Methods Using South Korea’s National Health Insurance Service sample cohort database, the 10-yr national trend of single-shot epidural injections for pain and the incidence rate of deep spinal infection after the procedure with its risk factors were determined. New-onset deep spinal infections were defined as those occurring within 90 days of the most recent outpatient single-shot epidural injection for pain, needing hospitalization for at least 1 night, and receiving at least a 4-week course of antibiotics. Results The number of outpatient single-shot epidural injections per 1,000 persons in pain practice doubled from 40.8 in 2006 to 84.4 in 2015 in South Korea. Among the 501,509 injections performed between 2007 and 2015, 52 cases of deep spinal infections were detected within 90 days postprocedurally (0.01% per injection). In multivariable analysis, age of 65 yr or more (odds ratio, 2.91; 95% CI, 1.62 to 5.5; P = 0.001), living in a rural area (odds ratio, 2.85; 95% CI, 1.57 to 5.0; P &lt; 0.001), complicated diabetes (odds ratio, 3.18; 95% CI, 1.30 to 6.7; P = 0.005), multiple epidural injections (three times or more) within the previous 90 days (odds ratio, 2.34; 95% CI, 1.22 to 4.2; P = 0.007), and recent use of immunosuppressants (odds ratio, 2.90; 95% CI, 1.00 to 6.7; P = 0.025) were significant risk factors of the infection postprocedurally. Conclusions The incidence of deep spinal infection after outpatient single-shot epidural injections for pain is very rare within 90 days of the procedure (0.01%). The data identify high-risk patients and procedure characteristics that may inform healthcare provider decision-making. Editor’s Perspective What We Already Know about This Topic What This Article Tells Us That Is New

scholarly journals NPHS2 gene mutation, atopy, and gender as risk factors for steroid-resistant nephrotic syndrome in Indonesians

2011 ◽  
Vol 51 (5) ◽  
pp. 272 ◽  
Author(s):  
Dedi Rachmadi ◽  
Danny Hilmanto ◽  
Ponpon Ijradinata ◽  
Abdurahman Sukadi
Keyword(s):  
Risk Factors ◽  
Nephrotic Syndrome ◽  
Gene Mutation ◽  
Significant Risk ◽  
Gene Mutations ◽  
Male Gender ◽  
Amplification Refractory Mutation System ◽  
Steroid Resistant ◽  
Steroid Resistant Nephrotic Syndrome ◽  
Nphs2 Gene

Background Steroid-resistant nephrotic syndrome (SRNS) often develops into end stage renal disease. Previous studies have reported that NPHS2 gene mutation, gender, and atopic history are risk factors associated with SRNS. Interethnic, sociocultural, and environmental differences have also been suggested to affect these mutations.Objective To analyze possible risk factors for SRNS, including NPHS2 gene mutations (412C→T and 419delG), gender and atopic history, in Indonesian subjects with SRNS.Methods A case-control study with 153 subjects, consisting of 88 SRNS patients and 65 control subjects, was undertaken in 10 Indonesian teaching centre hospitals from September 2006 to December 2007. Analysis of the NPHS2 gene mutation in 412 C→T was performed by amplification refractory mutation system-polymerase chain reaction (ARMS-PCR), while that for the NPHS2 gene mutation in 419delG was performed by restriction fragment length polymorphism (RFLP). Data was analyzed by multiple logistic regression.Results In our Indonesian subjects, the significant risk factors for SRNS were male gender (OR=2.21; CI 95%:1.07-4.56, P=0.036), NPHS2 412C→T gene mutation (OR=18.07; CI 95%:6.76-48.31, P<0.001), and NPHS2 419delG gene mutation (OR=4.55; CI 95%:1.66-12.47, P=0.003). However, atopic history was not a significant risk factor for SRNS (OR=1.807; CI 95%:0.642-5.086, P=0.262).Conclusion NPHS2 412C→T and 419delG gene mutations, as well as male gender are risk factors for SRNS in Indonesian subjects. Atopic history was not significantly associated with SRNS in our subjects. [Paediatr Indones. 2011;51:272-6].

Thoracoscopic esophagectomy with total meso-esophageal excision reduces regional lymph node recurrence

2018 ◽  
Vol 403 (8) ◽  
pp. 967-975 ◽  
Author(s):  
Yuji Akiyama ◽  
Takeshi Iwaya ◽  
Fumitaka Endo ◽  
Haruka Nikai ◽  
Kei Sato ◽  
...  
Keyword(s):  
Lymph Node ◽  
Regional Lymph Node ◽  
Thoracoscopic Esophagectomy ◽  
Lymph Node Recurrence

scholarly journals Development of Nomograms for Predicting Lymph Node Metastasis and Distant Metastasis in Newly Diagnosed T1-2 Non-Small Cell Lung Cancer: A Population-Based Analysis

2021 ◽  
Vol 11 ◽  
Author(s):  
Yiming Qi ◽  
Shuangshuang Wu ◽  
Linghui Tao ◽  
Yunfu Shi ◽  
Wenjuan Yang ◽  
...  
Keyword(s):  
Risk Factors ◽  
Lung Cancer ◽  
Lymph Node ◽  
Lymph Node Metastasis ◽  
Small Cell Lung Cancer ◽  
Distant Metastasis ◽  
Tumor Size ◽  
Small Cell ◽  
Small Cell Lung ◽  
Node Metastasis

BackgroundFor different lymph node metastasis (LNM) and distant metastasis (DM), the diagnosis, treatment and prognosis of T1-2 non-small cell lung cancer (NSCLC) are different. It is essential to figure out the risk factors and establish prediction models related to LNM and DM.MethodsBased on the surveillance, epidemiology, and end results (SEER) database from 1973 to 2015, a total of 43,156 eligible T1-2 NSCLC patients were enrolled in the retrospective study. Logistic regression analysis was used to determine the risk factors of LNM and DM. Risk factors were applied to construct the nomograms of LNM and DM. The predictive nomograms were discriminated against and evaluated by Concordance index (C-index) and calibration plots, respectively. Decision curve analysis (DCAs) was accepted to measure the clinical application of the nomogram. Cumulative incidence function (CIF) was performed further to detect the prognostic role of LNM and DM in NSCLC-specific death (NCSD).ResultsEight factors (age at diagnosis, race, sex, histology, T-stage, marital status, tumor size, and grade) were significant in predicting LNM and nine factors (race, sex, histology, T-stage, N-stage, marital status, tumor size, grade, and laterality) were important in predicting DM(all, P&lt; 0.05). The calibration curves displayed that the prediction nomograms were effective and discriminative, of which the C-index were 0.723 and 0.808. The DCAs and clinical impact curves exhibited that the prediction nomograms were clinically effective.ConclusionsThe newly constructed nomograms can objectively and accurately predict LNM and DM in patients suffering from T1-2 NSCLC, which may help clinicians make individual clinical decisions before clinical management.

scholarly journals Indications of Lymph Node Metastasis and Survival Analysis in T1N+M0 Gastric Cancer: a Population-Based Study

2020 ◽  
Author(s):  
Peng Jin ◽  
Yang Li ◽  
Shuai Ma ◽  
Wenzhe Kang ◽  
Hao Liu ◽  
...  
Keyword(s):  
Risk Factors ◽  
Gastric Cancer ◽  
Survival Analysis ◽  
Lymph Node ◽  
Lymph Node Metastasis ◽  
Tumor Size ◽  
Multivariate Analyses ◽  
Invasion Depth ◽  
Node Metastasis ◽  
Definition Of

Abstract Background Since the definition of early gastric cancer (EGC) was first proposed in 1971, the treatment of gastric cancer with or without lymph node metastasis (LNM) has changed a lot. The present study aims to identify risk factors for LNM and prognosis, and to further evaluate the indications for adjuvant chemotherapy (AC) in T1N + M0 gastric cancer. Methods A total of 1291 patients with T1N + M0 gastric cancer were retrieved from the Surveillance, Epidemiology, and End Results (SEER) database. Univariate and multivariate analyses were performed to identify risk factors for LNM. The effect of LNM on overall survival (OS) and cancer-specific survival (CSS) was compared with patients grouped into T1N0-1 and T1N2-3, as the indications for AC. Results The rate of LNM was 19.52%. Multivariate analyses showed age, tumor size, invasion depth, and type of differentiation and retrieved LNs were associated with LNM (p < 0.05). Cox multivariate analyses indicated age, sex, tumor size, N stage were independent predictors of OS and CSS (p < 0.05), while race was indicator for OS (HR 0.866; 95%CI 0.750–0.999, p = 0.049), but not for CSS (HR 0.878; 95% CI 0.723–1.065, p = 0.187). In addition, survival analysis showed the proportion of patients in N+/N0 was better distributed than N0-1/N2-3b. There were statistically significant differences in OS and CSS between patients with and without chemotherapy in pT1N1M0 patients (p༜0.05). Conclusions Both tumor size and invasion depth are associated with LNM and prognosis. LNM is an important predictor of prognosis. pT1N + M0 may be appropriate candidates for AC. Currently, the treatment and prognosis of T1N0M0/T1N + M0 are completely different. An updated definition of EGC, taking into tumor size, invasion depth and LNM, may be more appropriate in an era of precision medicine.

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