scholarly journals Clinical Heterogeneity of Differentiated Thyroid Cancer between Children Less than 10 Years of Age and Those Older than 10 Years: A Retrospective Study of 70 Cases

2021 ◽  
pp. 1-8
Author(s):  
Yuwei Liu ◽  
Shengcai Wang ◽  
Yanzhen Li ◽  
Xuexi Zhang ◽  
Zhiyong Liu ◽  
...  
Keyword(s):  
Risk Factors ◽  
Thyroid Cancer ◽  
Lymph Node ◽  
Retrospective Study ◽  
Lymph Node Metastasis ◽  
Distant Metastasis ◽  
Differentiated Thyroid Cancer ◽  
Age Groups ◽  
Clinical Heterogeneity ◽  
Node Metastasis

<b><i>Objectives:</i></b> The objectives of this study were to explore the clinical heterogeneity of differentiated thyroid cancer (DTC) between prepubertal children and adolescents and guide clinical treatment. <b><i>Methods:</i></b> A retrospective study included patients with DTC aged ≤19 years in Beijing Children’s Hospital from June 2014 to June 2019. All patients were enrolled and divided into 2 subgroups based on the threshold age of 10 years, namely the childhood group (CG) (≤10 years old); and the adolescent group (AG) (between 10 and 19 years old). The χ<sup>2</sup> test and Fisher’s exact test were used to estimate the effect of risk factors in the 2 age groups. Multivariate binary logistic regression models were conducted to assess the recurrent risk factors. <b><i>Results:</i></b> Seventy cases of DTC were included with an average age of 9.94 ± 2.88 years, including 35 in CG and 35 in AG. The most common clinical manifestation was a painless mass in the neck, accounting for 77.1% (54/70) of patients. Compared with the AG, the CG was more likely to have lymph node metastasis (<i>p</i> = 0.022) and distant metastasis (<i>p</i> = 0.041). The CG was more likely to have extrathyroidal extension (<i>p</i> = 0.012) and had a significantly higher recurrence rate than the AG (<i>p</i> = 0.040). Age was an independent variable predictive of recurrence (<i>p</i> = 0.0347). <b><i>Conclusion:</i></b> Regional invasiveness, cervical lymph node metastasis, and distant metastasis of DTC were more likely to occur in children ≤10 years old. Meanwhile, children ≤10 years old with DTC were more likely to have recurrence than adolescent’s postsurgical treatment. Thus, children younger than 10 years of age with DTC should be treated more aggressively.

scholarly journals Usefulness of Pre-Thyroidectomy Neutrophil-Lymphocyte, Platelet-Lymphocyte, and Monocyte-Lymphocyte Ratios in Discriminating Lymph Node and Distant Metastases in Differentiated Thyroid Cancer

2021 ◽  
Author(s):  
Cinthia Minatel Riguetto ◽  
Icléia Siqueira Barreto ◽  
Frederico Fernandes Ribeiro Maia ◽  
Ligia Vera Montali da Assumpção ◽  
Denise Engelbrecht Zantut-Wittmann
Keyword(s):  
Thyroid Cancer ◽  
Lymph Node ◽  
Lymph Node Metastasis ◽  
Distant Metastasis ◽  
Differentiated Thyroid Cancer ◽  
Response To Therapy ◽  
Lymphocyte Ratio ◽  
Node Metastasis ◽  
Disease Free ◽  
Active Disease

Abstract Purpose This study aims to show the relationship between neutrophil-lymphocyte ratio (NLR), platelet-lymphocyte ratio (PLR) and monocyte-lymphocyte ratio (MLR), with clinicopathological characteristics in patients with differentiated thyroid cancer (DTC). Methods This is a retrospective study involving 390 DTC patients who had complete blood cell count available at the time of the surgery. NLR, PLR, and MLR were calculated, risk of cancer-related death, structural recurrence, and response to therapy were assessed by the 8th edition of the tumor-node-metastasis (TNM), American Thyroid Association (ATA) Risk Stratification System, and ATA Response to Therapy Reclassification, respectively. Results PLR was higher in distant metastasis (133.15±43.95 vs 119.24±45.69, p = 0.0345), lower in disease-free versus persistent disease or death (117.72±44.70 vs 131.07±47.85, p = 0.0089). In MLR, patients ≥55 had a higher score than < 55 years old (0.26±0.10 vs 0.24±0.12, p = 0.0379). Higher MLR (OR 8.775; 95% CI = 1.532–50.273; p = 0.0147), intermediate (OR 4.892; 95% CI = 2.492–9.605; p ≤ 0.0001) and high ATA risks (OR 5.998; 95% CI = 3.126–11.505; p ≤ 0.0001) were risk factors associated with active disease. NLR was not significant. ROC curve cut-off values for NLR, PLR, and MLR were able to discriminate distant from lymph node metastasis (NLR > 1.93 sensitivity 73.3%, specificity 58.7%; PLR > 124.34 sensitivity 86.7%, specificity 69.2%; MLR > 0.21 sensitivity 80%, specificity 45.2%). Conclusion Cut-off values of NLR, PLR, and MLR discriminated the presence of distant metastasis from lymph node metastasis with good sensitivity and accuracy. PLR was an associated factor with disease-free status and higher in DTC patients with distant metastasis, persistency, and disease-related death. MLR was a risk factor of active disease.

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.

The Implication of Lymph Node Metastasis on Survival in Patients with Well-Differentiated Thyroid Cancer

2005 ◽  
Vol 71 (9) ◽  
pp. 731-734 ◽  
Author(s):  
Yale D. Podnos ◽  
David Smith ◽  
Lawrence D. Wagman ◽  
Joshua D.I. Ellenhorn
Keyword(s):  
Thyroid Cancer ◽  
Lymph Node ◽  
Lymph Node Metastasis ◽  
Tumor Size ◽  
Large Scale ◽  
Differentiated Thyroid Cancer ◽  
Lymph Node Status ◽  
Large Tumor ◽  
Node Metastasis ◽  
Well Differentiated

Though survival for well-differentiated thyroid cancer is very good, specific populations suffer greater recurrence and mortality. Defining these cohorts can significantly influence prognosis and extent of treatment. This study, using a large, multi-institutional database, seeks to determine how the presence of lymph node disease in patients with well-differentiated thyroid cancer affects outcome. The Surveillance, Epidemiology, and End Results (SEER) database is a large-scale sample of 14 per cent of the U.S. population. It was used to identify patients with papillary and follicular thyroid carcinomas and identify the prognostic implications of lymph node metastasis. Additional factors, including presence of metastasis, age, and tumor size, were compared using multivariate and χ2 analyses. Of 19,918 patients identified, lymph node status was known for 9,904 (49.7%). On multivariate analysis, age >45 years, presence of distant metastasis, large tumor size, and lymph node involvement significantly predicted poor outcome. Overall survival at 14 years was 82 per cent for node negative and 79 per cent for node positive patients ( P < 0.05). This study shows that the survival of patients with well-differentiated thyroid cancer is adversely affected by lymph node metastases. The optimum treatment for this cohort needs further delineation, as particular populations are at greater risk of recurrence and death.

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