World Congress on Thyroid Cancer 4.0
July 29 – August 1, 2021
WCTC3.5 Steering Committee:
Rocco Bellantone, Co-Chair
Celestino Lombardi, Co-Chair
Gregory W. Randolph, MD
Bryan McIver, MD
Jeremy Freeman, MD
Ian J. Witterick, MD
Ashok R. Shaha, MD
Jatin P. Shah, MD
OP68 – Prevalence of Central Lymph Node Metastasis in Papillary Thyroid Cancer Patients with Uncertain Sonographic Patterns in the Preoperative Staging Ultrasound
Plass, Ingrid2; Tala, Hernan1; Horvath, Eleonora3, Gonzalez, Paulina3; NIedman, JuanPablo3; Whittle, Carolina3; Capdeville, Felipe4; Madrid, Arturo4; Rojas, Hugo4; Rossi, Ricardo4, Valdes, Fabio4, Slater, Jeannie5.
1 Department of Endocrinilogy, Thyroid Center Division, Clinica Alemana de Santiago, Facultad de Medicina, Universidad del Desarrollo, Santiago, Chile
2 Head and Neck Surgery Resident, Clínica Alemana de Santiago, Facultad de Medicina, Universidad del Desarrollo, Santiago, Chile
3 Department of Radiology, Thyroid Center Division, Clinica Alemana de Santiago, Facultad de Medicina, Universidad del Desarrollo, Santiago, Chile
4 Department of Surgery, Head and Neck Surgery Division, Thyroid Center Division, Clinica Alemana de Santiago, Facultad de Medicina, Universidad del Desarrollo, Santiago, Chile
5 Department of Pathology, Thyroid Center Division, Clinica Alemana de Santiago, Facultad de Medicina, Universidad del Desarrollo, Santiago, Chile
Background/Purpose: The clinical relevance of central lymph nodes (CLNs) with uncertain sonographic patterns (CLNUSP) on preoperative staging ultrasound (US) in Papillary Thyroid Carcinoma (PTC) still is not clear. We aim to establish the prevalence of clinically relevant CLNs metastasis (CRCM) in PTC patients with CLNUSP that underwent CLNs resection, either in the presence or absence of Hashimoto’s thyroiditis (HT).
Methods: Retrospective IRB approved review of PTC patients with CLNUSP who underwent CLNs resection between 2013-2017 was performed. CLNUSP was defined as: prominent CLNs associated to HT or CLNs located next to the PTC identified. We excluded patients with suspicious CLNS on US. The US characteristics of CLNs and the presence or absence of HT on US was correlated with their pathological report. CRCM were defined as >5 metastatic CLNs (any size) or any metastasis >2mm. Prevalence of CRCM in patients with and without HT on US was assessed.
Results: We reviewed 116 patients (80% women, median age 39 years). CLNs metastasis were present in 46%(53/116), 30% being CRCM (35/116). Amongst them, 13%(15/116) correspond to CRCM between 2-5mm and 17%(20/116) between 5-10mm.
Prevalence of CRCM was 21%(15/70) and 46%(18/39) in patients with and without HT, respectively (p=0,007).
Discussion and Conclusion: A third of patients with CLNUSP presented CRCM between 2-10mm, and a non-negligible 17% were between 5-10mm. When HT is present on US, 21% of patients with CLNUSP had CRCM. This should be taken in consideration in the decision whether to perform or not CLNs resection in this subgroup of patients.
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