Oncotarget

Research Papers:

Patterns and clinical significance of cervical lymph node metastasis in papillary thyroid cancer patients with Delphian lymph node metastasis

Guibin Zheng, Hua Zhang, Shaolong Hao, Chengxin Liu, Jie Xu, Jinyao Ning, Guochang Wu, Lixin Jiang, Guojun Li, Haitao Zheng _ and Xicheng Song

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Oncotarget. 2017; 8:57089-57098. https://doi.org/10.18632/oncotarget.19047

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Abstract

Guibin Zheng1,*, Hua Zhang2,*, Shaolong Hao1, Chengxin Liu1, Jie Xu1, Jinyao Ning1, Guochang Wu1, Lixin Jiang1, Guojun Li3,4, Haitao Zheng1 and Xicheng Song2

1Department of Thyroid Surgery, The Affiliated Yantai Yuhuangding Hospital of Qingdao University, Yantai, Shandong Province, 264000, China

2Department of Otolaryngology-Head and Neck Surgery, The Affiliated Yantai Yuhuangding Hospital of Qingdao University, Yantai, Shandong Province, 264000, China

3Departments of Head and Neck Surgery, The University of Texas MD Anderson Cancer Center, Houston, TX 77030, U.S.A.

4Department of Epidemiology, The University of Texas MD Anderson Cancer Center, Houston, TX 77030, U.S.A.

*These authors contributed equally to this work and are considered co-first authors

Correspondence to:

Haitao Zheng, email: [email protected]

Xicheng Song, email: [email protected]

Keywords: Delphian lymph node, papillary thyroid cancer, central neck node metastases, lateral neck node metastases

Received: February 22, 2017     Accepted: June 19, 2017     Published: July 06, 2017

ABSTRACT

Although the roles of Delphian lymph node (DLN) metastasis in papillary thyroid cancer (PTC) have been previously reported, there are still limited data on correlations of clinicopathologic factors with DLN metastasis and unique patterns of cervical node subsite metastasis in PTC patients with DLN metastasis. We retrospectively reviewed medical records of 320 patients with a diagnosis of PTC who underwent primary surgery. Clinicopathologic features and DLN metastasis patterns were analyzed for predicting extensive cervical lymph node metastasis. Both univariate and multivariate Cox regression analyses were used to identify independent factors for cervical lymph node metastasis. DLN metastasis was significantly associated with multifocality, tumor size > 1 cm, extrathyroid extension, BRAFV600E mutation, central neck node metastasis (CNNM), and lateral neck nodes metastases. Patients with DLN metastasis had more lymph node metastases in the central compartment. CNNM number and tumor size > 1 cm were independent risk factors for DLN metastasis. DLN metastasis was highly predictive of lateral lymph node metastasis with moderate sensitivity and high specificity. DLN metastasis is associated with several poor prognostic factors, including extensive cervical lymph node metastasis, and can serve as a predictor of advanced PTC. The presence of DLN metastasis should prompt surgeons to perform an aggressive surgery approach.


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