Open Access

The effect of the area proportion of the metastatic lesion within the central metastatic lymph node on response to therapy in papillary thyroid carcinoma

  • Authors:
    • Liuhong Shi
    • Liang Zhou
    • Jianbiao Wang
    • Lei Jin
    • Yinjiao Lei
    • Lian Xia
    • Lei Xie
  • View Affiliations

  • Published online on: February 12, 2021     https://doi.org/10.3892/ol.2021.12545
  • Article Number: 284
  • Copyright: © Shi et al. This is an open access article distributed under the terms of Creative Commons Attribution License.

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Abstract

Lymph node (LN) metastasis has been strongly associated with locoregional recurrence and decreased survival time of patients with papillary thyroid carcinoma (PTC). Although the characteristics of the metastatic LNs (mLN) have been determined, including size, number, micro‑metastasis and extra‑nodal extension (ENE), further analysis is warranted. The present study introduced a new parameter known as the area proportion of the metastatic lesion within the central mLNs (APmCLN). The objective was to evaluate the impact of the APmCLN on response to therapy in patients with PTC. In total, 355 patients with PTC treated with total thyroidectomy and neck dissection, post‑operative radioactive iodine and thyroid‑stimulating hormone suppression were retrospectively studied. The patients were classified into two groups: Group A (APmCLN ≤75%) and group B (APmCLN >75%). The association of various clinicopathological characteristics between these two groups was investigated. Univariate and multivariate analyses were used to evaluate risk factors associated with a non‑Excellent response to therapy and recurrence‑free survival (RFS). The analysis showed that APmCLN >75% was significantly associated with extra‑thyroidal extension, clinically apparent nodes (cN1), pathological N1b (pN1b), ENE, greater number and larger size of central mLN and larger size of the central LN metastatic lesion. Furthermore, it was reported that chronic lymphocytic thyroiditis, larger central mLN size and APmCLN >75% were independent risk factors for a non‑excellent response to therapy. Finally, it was determined that the rate of excellent response to therapy was significantly higher in pathological N1 (pN1) patients with APmCLN ≤75% (108/144, 75.0%) compared with patients with APmCLN >75% (27/47, 57.4%) (P=0.022). However, there was no significant difference (P=0.247) between patients with APmCLN ≤75% and pN0 (132/164, 80.5%). RFS was 89.4% in patients with pN1‑APmCLN >75%, whereas those with pN1‑APmCLN ≤75% and pN0 did not experience a relapse. Patients with PTC with APmCLN >75% should be regarded as high‑risk and may require more aggressive treatment and careful follow‑up.
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April-2021
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Spandidos Publications style
Shi L, Zhou L, Wang J, Jin L, Lei Y, Xia L and Xie L: The effect of the area proportion of the metastatic lesion within the central metastatic lymph node on response to therapy in papillary thyroid carcinoma. Oncol Lett 21: 284, 2021.
APA
Shi, L., Zhou, L., Wang, J., Jin, L., Lei, Y., Xia, L., & Xie, L. (2021). The effect of the area proportion of the metastatic lesion within the central metastatic lymph node on response to therapy in papillary thyroid carcinoma. Oncology Letters, 21, 284. https://doi.org/10.3892/ol.2021.12545
MLA
Shi, L., Zhou, L., Wang, J., Jin, L., Lei, Y., Xia, L., Xie, L."The effect of the area proportion of the metastatic lesion within the central metastatic lymph node on response to therapy in papillary thyroid carcinoma". Oncology Letters 21.4 (2021): 284.
Chicago
Shi, L., Zhou, L., Wang, J., Jin, L., Lei, Y., Xia, L., Xie, L."The effect of the area proportion of the metastatic lesion within the central metastatic lymph node on response to therapy in papillary thyroid carcinoma". Oncology Letters 21, no. 4 (2021): 284. https://doi.org/10.3892/ol.2021.12545