중심 경부 림프절 전이가 있는 갑상샘 유두암에서 전이 림프절 비율, 림프절 피막외 침범의 관련 인자 분석

박찬우; 송준웅; 천봉권; 김성원; 이형신; 홍종철; 이강대

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자료유형: 학술저널

저자정보: 박찬우 송준웅 천봉권 김성원 이형신 홍종철 이강대

저널정보: 대한이비인후과학회 대한이비인후-두경부외과학회지 대한이비인후과학회지 두경부외과학 제58권 제7호

발행연도: 2015.1

수록면: 475 - 480 (6page)

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Background and Objectives Lymph node (LN) metastasis occurs in 30-80% of patients presenting for initial treatment of papillary thyroid carcinoma (PTC). The presence of LN metastasis is an independent risk factor for recurrence, which can add significant treatment morbidity. The LN ratio (LNR) and extranodal extension (ENE) have been shown to be important prognostic factors in PTC. The purpose of this study was to assess the characteristic features of LNR and ENE. Subjects and Method We undertook a retrospective study of 411 patients treated between January, 2011 and December, 2013 for central compartment node-positive PTC by thyroidectomy and central compartment neck dissection (CCND) at our institution. We compared various clinicopathologic parameters such as age, gender, tumor size, multifocality, bilaterality, local invasion, extrathyroidal extension and aggressive variants between LNR and ENE. Results The signifi cant associated factors for high LNR (defi ned as higher than 0.5) in multivariate analysis were gender (p=0.001, odds ratio=2.285) and multifocality (p=0.027, odds ratio=2.092). On the other hand, the signifi cant associated factors for ENE in multivariate analysis were primary tumor size (p=0.023, odds ratio=1.965) and local invasion (p=0.043, odds ratio=1.870). Conclusion Being male, multifocality, large primary tumor size (defi ned as larger than 1 cm) and local invasion were revealed as associated factors for LNR and ENE. Therefore, elective CCND should be considered for patients with PTC, for whom a thorough investigation of associative factors should be made before surgery.

#Lymphatic metastasis #Papillary carcinoma #Thyroid neoplasm

참고문헌 (14)

참고문헌 신청

Attie JN / 1988 / Modified neck dissection in treatment of thyroid cancer:a safe procedure / Eur J Cancer Clin Oncol 24 (2) : 315 ~ 324

Chow SM / 2003 / Papillary microcarcinoma of the thyroid-Prognostic significance of lymph node metastasis and multifocality / Cancer 98 (1) : 31 ~ 40

Clark OH / 2011 / Thyroid cancer and lymph node metastases / J Surg Oncol 103 (6) : 615 ~ 618

Harwood J / 1978 / Significance of lymph node metastasis in differentiated thyroid cancer / Am J Surg 136 (1) : 107 ~ 112

Ito Y / 2007 / Extranodal tumor extension to adjacent organs predicts a worse cause-specific survival in patients with papillary thyroid carcinoma / World J Surg 31 (6) : 11

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