EP64 – Right upper paraesophageal lymph node is a novel predictive factor of locoregional recurrence in right side PTC

      Shin, Sung-Chan1; Kwon, Hyun-Keun1; Sung, Eui Suk2; Jeon, Yun Kyung3; Kim, Bo Hyun3; Kim, In Joo3; Lee, Jin-Choon2; Wang, Soo-Geun1; Lee, Byung-Joo1 1 Department of Otorhinolaryngology Head and Neck Surgery, Pusan National University Hospital, Busan, Korea 2 Department of Otorhinolaryngology Head and Neck Surgery, Pusan National University Yangsan Hospital, Busan, Korea 3 Division of Endocrinology and Metabolism, Department of Internal Medicine, Pusan National University Hospital, Busan, Korea   Background: Central lymph node metastasis is associated with prognostic factors for locoregional recurrence. Right upper paraesophageal lymph nodes(UPELNs) are often overlooked during central-compartment lymph node dissection(CLND) for papillary thyroid carcinoma(PTC) patients. Therefore, we investigated the related factors and the prognostic implication of loco-regional recurrence for right UPELN metastasis in right-side PTC. Methods: Records from 763 patients with PTC who underwent total thyroidectomy with CLND including right UPELNs were reviewed retrospectively between January 2007 and March 2015. Results: 127 of 763 patients with right-side PTC exhibited nodal metastasis in right UPELNs. In univariate analysis, Right UPELN metastasis was significantly associated with gender, tumor size(>10mm), T stage, extrathyroid extension(ETE), lateral neck lymph node metastasis (p<0.05, respectively). In multivariate analysis, central compartment lymph node(CLN) metastasis (OR 5.203, 95% CI 2.864-9.453), lateral neck lymph node (LLN) metastasis (OR 3.668 , 95% CI 2.375-5.667) were independently correlated with right UPELN metastasis. Right CLN metastasis and UPELN metastasis predicted significantly right LLN metastasis (OR 3.777, 10.325, respectively, p<0.001). 23 (3.0%) patient revealed loco-regional recurrence. Comparing the recurrence rate in the group with CLN metastasis and the group with right UPELN metastasis, the recurrence rate was significantly higher in the group with right UPELN metastasis (p<0.001). Conclusions: Right CLN metastasis and lateral LN metastasis were significantly independent predictors of right UPELN metastasis. In addition, the loco-regional recurrence rate was significantly higher in the patients with right UPELN metastasis. These results suggested that right UPELN metastasis should be considered as a novel prognostic factor for locoregional recurrence in right-side PTC.   References:
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