Risk factors for right paraesophageal lymph node metastasis in papillary thyroid carcinoma: A meta-analysis |
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| Affiliation: | 1. Ultrasound Department, Beijing Friendship Hospital, Capital Medical University, Beijing, China;2. Ultrasound Department, Thomas Jefferson University, Philadelphia, PA, USA;3. Pathology Department, Beijing Friendship Hospital, Capital Medical University, Beijing, China;4. Laboratory Department, Beijing Friendship Hospital, Capital Medical University, Beijing, China;1. Radiology Department, Galway University Hospital, Galway, Ireland;2. Endocrinology Department, Galway University Hospital, Galway, Ireland;3. Radiology Department, National University of Ireland, Galway, Ireland;1. The First Department of Head and Neck Surgery, Harbin Medical University Cancer Hospital, Harbin, China;2. Department of Microbiology, Harbin Medical University, Harbin, China;3. Anesthesiology Department, The Fourth Affiliated Hospital of Harbin Medical University, Harbin, China;1. Key Laboratory of Carcinogenesis and Translational Research (Ministry of Education/Beijing), Department of Head and Neck Surgery, Peking University Cancer Hospital and Institute, Beijing, China;2. Key Laboratory of Carcinogenesis and Translational Research (Ministry of Education/Beijing), Department of Pathology, Peking University Cancer Hospital and Institute, Beijing, China;1. General Surgery Department, Peking Union Medical College Hospital, Beijing, 100730, China;2. Ultrasonography Department, Peking Union Medical College Hospital, Beijing, 100730, China;3. Institute of Basic Medical Sciences, Chinese Academy of Medical Science, School of Basic Medicine, Peking Union Medical College, Beijing, 100005, China;1. Division of Endocrinology and Metabolism, Department of Internal Medicine, Biomedical Research Institute, Pusan National University Hospital, Busan, Republic of Korea;2. Department of Internal Medicine, Chonnam National University Medical School, Gwangju, Republic of Korea;3. Division of Endocrinology and Metabolism, Department of Medicine, Samsung Changwon Hospital, Sungkyunkwan University School of Medicine, Changwon, Republic of Korea;4. Division of Endocrinology and Metabolism, Department of Internal Medicine, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Republic of Korea;5. Department of Internal Medicine, Chungnam National University Hospital, Chungnam National University School of Medicine, Daejeon, Republic of Korea;6. Department of Internal Medicine, Ulsan University Hospital, University of Ulsan College of Medicine, Ulsan, Republic of Korea;7. Division of Endocrinology, Department of Medicine, Gyeongsang National University Changwon Hospital, Gyeongsang National University School of Medicine, Changwon, Republic of Korea;8. Division of Endocrinology and Metabolism, Department of Medicine, Thyroid Cancer, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea |
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| Abstract: | ObjectiveProphylactic dissection of the right paraesophageal lymph node (RPELN) in thyroid cancer is controversial. We performed a meta-analysis to provide evidence for RPELN dissection in thyroid cancer.MethodsWe searched the PubMed and Science Citation Index Expanded (SCIE) databases for relevant studies published up to January 31, 2019. The patients involved all had a pathological diagnosis of papillary thyroid cancer (PTC) and had undergone total thyroidectomy or right lobectomy with central compartment lymph node dissection. The RPELNs had been kept aside during the operation.ResultsFourteen cohort studies involving 11,090 patients with PTC were included in the meta-analysis. There was RPELN metastases (RPELNM) in 1038 patients (9.36%). The factors related to RPELNM were: age <45 years, male sex, right lobe tumor, tumor >1 cm, extrathyroidal extension, capsular invasion, right paratracheal lymph node metastasis (RPTLNM), central lymph node metastasis (CLNM), lateral lymph node metastasis (LLNM), and tumor multifocality. There was no association between RPELNM and Hashimoto's thyroiditis (HT) and inferior pole tumors or tumor in the middle of the gland. With superior pole tumors, there was even less RPELNM.ConclusionsThe clinical features related to RPELNM are age <45 years, male sex, tumor >1 cm, tumor diameter >2 cm, right lobe tumor, RPTLNM, extrathyroidal extension, capsular invasion, CLNM, CLNM ≥3, LLNM and multifocality, which should be considered when evaluating RPELN dissection. |
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| Keywords: | Papillary thyroid carcinoma Right paraesophageal lymph node Risk factors |
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