Preoperative Ultrasonography Predicts Level II Lymph Node Metastasis in N1b Papillary Thyroid Carcinoma: Implications for Surgical Planning

作者：Na Lae Eun, Jeong‐Ah Kim, Yangkyu Lee, Ji Hyun Youk, Hyeok Jun Yun, Hojin Chang, Seok‐Mo Kim, Yong Sang Lee, Hang‐Seok Chang, Hyejin Yang, Soyoung Jeon, Eun Ju Son · 发表于：Biomedicines · 年份：2024 · DOI：10.3390/biomedicines12071588 · 被引用次数：3 · 研究领域：Thyroid Cancer Diagnosis and Treatment、Thyroid and Parathyroid Surgery、Multiple and Secondary Primary Cancers

Purpose: To investigate whether preoperative ultrasonographic (US) features of the index cancer and metastatic lymph nodes (LNs) are associated with level II LN metastasis in N1b papillary rmfthyroid carcinoma (PTC) patients. Materials and methods: We enrolled 517 patients (mean age, 42 [range, 6–80] years) who underwent total thyroidectomy and lateral compartment LN dissection between January 2009 and December 2015. We reviewed the clinicopathologic and US features of the index cancer and metastatic LNs in the lateral neck. Logistic regression analysis was performed to analyze features associated with level II LN metastasis. Results: Among the patients, 196 (37.9%) had level II metastasis on final pathology. In the preoperative model, larger tumor size (odds ratios [ORs], 1.031; 95% confidence interval [CI]: 1.011–1.051, p = 0.002), nonparallel tumor shape (OR, 1.963; 95% CI: 1.322–2.915, p = 0.001), multilevel LN involvement (OR, 1.906; 95% CI: 1.242–2.925, p = 0.003), and level III involvement (OR, 1.867; 95% CI: 1.223–2.850, p = 0.004), were independently associated with level II LN metastasis. In the postoperative model, non-conventional pathology remained a significant predictor for level II LN metastasis (OR, 1.951; 95% CI: 1.121–3.396; p = 0.018), alongside the presence of extrathyroidal extension (OR, 1.867; 95% CI: 1.060–3.331; p = 0.031), and higher LN ratio (OR, 1.057; 95% CI: 1.039–1.076; p < 0.001). Conclusions: Preoperative US features of the index tumor and...