20. Occult lymph node micrometastases in patients with papillary thyroid cancer treated by toetva and related factors
Main Article Content
Abstract
This cross-sectional study assessed central cervical lymph node micro metastasis and related factors in patients with papillary thyroid cancer undergoing transoral endoscopic thyroidectomy vestibular approach (TOETVA). This study was conducted in 346 patients who underwent TOETVA to treat thyroid cancer in Department of Oncology and Palliative Care at Hanoi Medical University Hospital between January 2020 and December 2021. The clinical, surgical, and pathological characteristics were recorded. The rate of occult lymph node micro metastases was 39,9%. The average number of harvested lymph nodes was 5.98 ± 4.1 (range: 0 - 24) lymph nodes. The average number of micrometastases nodes was 1.04 ± 1.7 (range: 0 - 10) lymph nodes. On average, thyroiditis significantly increased the number of harvested lymph nodes by 8.3 ± 0.7 (range: 1 - 24) (p = 0.002). Tumor size on ultrasound and stage of tumor significantly increased the likelihood of occult lymph node micrometastase (p < 0.05). The stage of tumor was the only factor increased the likelihood of having more-than-5 occult lymph node micro metastases.
Article Details
Keywords
Thyroid cancer, central lymph node metastasis, TOETVA
References
2. Hau Nguyen Xuan, Huy Trinh Le, Hien Nguyen Xuan, Hung Tran Tuan, Hung Nguyen Van, Quang Le Van. Preliminary Experience with Transoral Endoscopic Thyroidectomy and Parathyroidectomy via Vestibular Approach
3. Ahn J hyuk, Yi JW. Transoral endoscopic thyroidectomy for thyroid carcinoma: outcomes and surgical completeness in 150 single-surgeon cases. Surg Endosc. 2020; 34(2): 861-867. doi:10.1007/s00464-019-06841-8.
4. Nguyen HX, Nguyen HX, Nguyen TTP, Van Le Q. Transoral endoscopic thyroidectomy by vestibular approach in Viet Nam: surgical outcomes and long-term follow-up. Surg Endosc. 2022; 36(6): 4248-4254. doi:10.1007/s00464-021-08759-6.
5. Haugen BR, Alexander EK, Bible KC, et al. 2015 American Thyroid Association Management Guidelines for Adult Patients with Thyroid Nodules and Differentiated Thyroid Cancer: The American Thyroid Association Guidelines Task Force on Thyroid Nodules and Differentiated Thyroid Cancer. Thyroid. 2016; 26(1): 1-133. doi:10.1089/thy.2015.0020.
6. Haddad RI, Nasr C, Bischoff L, et al. NCCN Guidelines Insights: Thyroid Carcinoma, Version 2.2018. Journal of the National Comprehensive Cancer Network. 2018; 16(12): 1429-1440. doi:10.6004/jnccn.2018.0089.
7. Choi SM, Kim JK, Lee CR, et al. Completion Total Thyroidectomy Is Not Necessary for Papillary Thyroid Microcarcinoma with Occult Central Lymph Node Metastasis: A Long-Term Serial Follow-Up. Cancers (Basel). 2020; 12(10): E3032. doi:10.3390/cancers12103032
8. Song E, Jeon MJ, Park S, et al. Influence of coexistent Hashimoto’s thyroiditis on the extent of cervical lymph node dissection and prognosis in papillary thyroid carcinoma. Clin Endocrinol (Oxf). 2018; 88(1): 123-128. doi:10.1111/cen.13475.