The impact of ipsilateral central neck dissection on the 2015 american thyroid association risk stratification system and tnm staging in papillary thyroid carcinoma
Autor(a) principal: | |
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Data de Publicação: | 2019 |
Outros Autores: | , , , , , |
Tipo de documento: | Artigo |
Idioma: | eng |
Título da fonte: | Repositório Institucional da UFMG |
Texto Completo: | https://dx.doi.org/10.18203/issn.2454-5929.ijohns20190754 http://hdl.handle.net/1843/43765 |
Resumo: | Background: In patients with classic papillary thyroid carcinoma (PTC) and no clinical evidence of lymph node metastasis (cN0), elective central neck dissection remains controversial. This study evaluates whether elective ipsilateral central neck dissection (eICND) along with total thyroidectomy could modify the staging of these patients. Additionally, we aim to assess pN1 risk factors, the incidence of post-operative complications, and the correlation between pN1 and change in tumor classification according to the risk stratification score of the American thyroid association 2015 (ATA 2015-RSS) and the TNM Score. Methods: This is a prospective, observational study, involving 46 patients with cN0 PTC who underwent eICND along with total thyroidectomy. The number of metastatic lymph nodes, the largest lymph node metastasis, and the extra-nodal extension were assessed. Results: 22 out of 46 patients (47.8%; CI 32.9–63.1) presented lymph node metastasis. Seventeen out of the 45 patients initially classified as low or intermediate ATA 2015-RSS upgraded their risk staging (37.8%; CI 23.8–53.5). Fourteen out of these reclassified patients had their initial ATA 2015-RSS changed due to lymph node metastasis larger than 2 mm (mostly between 3 mm and 4 mm). Ten out of 46 (21.7%; CI 10.49–36.4) patients had their TNM staging reviewed. General complication rate was 17.4% (8/46). Conclusions: Elective dissection of levels VI ipsilateral and VII showed the ability to upgrade the initial ATA 2015-RSS and TNM staging in patients with cN0 PTC. However, further studies are necessary to evaluate the clinical impact of lymph node micro-metastasis. |
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2022-07-28T20:53:04Z2022-07-28T20:53:04Z201952https://dx.doi.org/10.18203/issn.2454-5929.ijohns2019075424545937http://hdl.handle.net/1843/43765Background: In patients with classic papillary thyroid carcinoma (PTC) and no clinical evidence of lymph node metastasis (cN0), elective central neck dissection remains controversial. This study evaluates whether elective ipsilateral central neck dissection (eICND) along with total thyroidectomy could modify the staging of these patients. Additionally, we aim to assess pN1 risk factors, the incidence of post-operative complications, and the correlation between pN1 and change in tumor classification according to the risk stratification score of the American thyroid association 2015 (ATA 2015-RSS) and the TNM Score. Methods: This is a prospective, observational study, involving 46 patients with cN0 PTC who underwent eICND along with total thyroidectomy. The number of metastatic lymph nodes, the largest lymph node metastasis, and the extra-nodal extension were assessed. Results: 22 out of 46 patients (47.8%; CI 32.9–63.1) presented lymph node metastasis. Seventeen out of the 45 patients initially classified as low or intermediate ATA 2015-RSS upgraded their risk staging (37.8%; CI 23.8–53.5). Fourteen out of these reclassified patients had their initial ATA 2015-RSS changed due to lymph node metastasis larger than 2 mm (mostly between 3 mm and 4 mm). Ten out of 46 (21.7%; CI 10.49–36.4) patients had their TNM staging reviewed. General complication rate was 17.4% (8/46). Conclusions: Elective dissection of levels VI ipsilateral and VII showed the ability to upgrade the initial ATA 2015-RSS and TNM staging in patients with cN0 PTC. However, further studies are necessary to evaluate the clinical impact of lymph node micro-metastasis.Fundamento: Em pacientes com carcinoma papilífero de tireoide (CPT) clássico e sem evidência clínica de metástase linfonodal (cN0), o esvaziamento cervical central eletivo permanece controverso. Este estudo avalia se o esvaziamento cervical central ipsilateral eletivo (eICND) associado à tireoidectomia total poderia modificar o estadiamento desses pacientes. Além disso, pretendemos avaliar os fatores de risco pN1, a incidência de complicações pós-operatórias e a correlação entre pN1 e mudança na classificação do tumor de acordo com o escore de estratificação de risco da American thyroid Association 2015 (ATA 2015-RSS) e o TNM Score . Métodos: Trata-se de um estudo prospectivo, observacional, envolvendo 46 pacientes com CPT cN0 submetidos a eICND juntamente com tireoidectomia total. Foram avaliados o número de linfonodos metastáticos, a maior metástase linfonodal e a extensão extranodal. Resultados: 22 dos 46 pacientes (47,8%; IC 32,9–63,1) apresentaram metástase linfonodal. Dezessete dos 45 pacientes inicialmente classificados como ATA 2015-RSS baixo ou intermediário atualizaram seu estadiamento de risco (37,8%; IC 23,8–53,5). Quatorze desses pacientes reclassificados tiveram seu ATA 2015-RSS inicial alterado devido a metástases linfonodais maiores que 2 mm (principalmente entre 3 mm e 4 mm). Dez dos 46 (21,7%; IC 10,49–36,4) pacientes tiveram seu estadiamento TNM revisado. A taxa geral de complicações foi de 17,4% (8/46). Conclusões: A dissecção eletiva dos níveis VI e VII ipsilaterais mostrou a capacidade de atualizar o estadiamento inicial ATA 2015-RSS e TNM em pacientes com PTC cN0. No entanto, mais estudos são necessários para avaliar o impacto clínico da micrometástase linfonodal.engUniversidade Federal de Minas GeraisUFMGBrasilICX - DEPARTAMENTO DE ESTATÍSTICAMED - DEPARTAMENTO DE CIRURGIAInternational journal of otorhinolaryngology and head and neck surgeryTireóideEstadiamento da NeoplasiaCarcinoma PapilíferoDissecção do PescoçoThe impact of ipsilateral central neck dissection on the 2015 american thyroid association risk stratification system and tnm staging in papillary thyroid carcinomaO impacto do esvaziamento cervical central ipsilateral no sistema de estratificação de risco da associação americana de tireoide de 2015 e no estadiamento TNM no carcinoma papilífero de tireoideinfo:eu-repo/semantics/publishedVersioninfo:eu-repo/semantics/articlehttps://www.ijorl.com/index.php/ijorl/article/view/1210Gustavo Cancela e PennaPatricia CorradiHenrique MendesCynthia. BerensteinMagda. PiresBernardo FonsecaGustavo Moraesapplication/pdfinfo:eu-repo/semantics/openAccessreponame:Repositório Institucional da UFMGinstname:Universidade Federal de Minas Gerais (UFMG)instacron:UFMGLICENSELicense.txtLicense.txttext/plain; charset=utf-82042https://repositorio.ufmg.br/bitstream/1843/43765/1/License.txtfa505098d172de0bc8864fc1287ffe22MD51ORIGINAL2019_The impact of ipsilateral central neck dissection on the 2015 american thyroid association risk stratification system and tnm staging in papillary thyroid carcinoma.pdf2019_The impact of ipsilateral central neck dissection on the 2015 american thyroid association risk stratification system and tnm staging in papillary thyroid carcinoma.pdfapplication/pdf278063https://repositorio.ufmg.br/bitstream/1843/43765/2/2019_The%20impact%20of%20ipsilateral%20central%20neck%20dissection%20on%20the%202015%20american%20thyroid%20association%20risk%20stratification%20system%20and%20tnm%20staging%20in%20papillary%20thyroid%20carcinoma.pdf55c9cd3cbf5e729bb2f5a0a2bc1e402dMD521843/437652022-07-28 17:53:04.16oai:repositorio.ufmg.br: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Repositório de PublicaçõesPUBhttps://repositorio.ufmg.br/oaiopendoar:2022-07-28T20:53:04Repositório Institucional da UFMG - Universidade Federal de Minas Gerais (UFMG)false |
dc.title.pt_BR.fl_str_mv |
The impact of ipsilateral central neck dissection on the 2015 american thyroid association risk stratification system and tnm staging in papillary thyroid carcinoma |
dc.title.alternative.pt_BR.fl_str_mv |
O impacto do esvaziamento cervical central ipsilateral no sistema de estratificação de risco da associação americana de tireoide de 2015 e no estadiamento TNM no carcinoma papilífero de tireoide |
title |
The impact of ipsilateral central neck dissection on the 2015 american thyroid association risk stratification system and tnm staging in papillary thyroid carcinoma |
spellingShingle |
The impact of ipsilateral central neck dissection on the 2015 american thyroid association risk stratification system and tnm staging in papillary thyroid carcinoma Gustavo Cancela e Penna Tireóide Estadiamento da Neoplasia Carcinoma Papilífero Dissecção do Pescoço |
title_short |
The impact of ipsilateral central neck dissection on the 2015 american thyroid association risk stratification system and tnm staging in papillary thyroid carcinoma |
title_full |
The impact of ipsilateral central neck dissection on the 2015 american thyroid association risk stratification system and tnm staging in papillary thyroid carcinoma |
title_fullStr |
The impact of ipsilateral central neck dissection on the 2015 american thyroid association risk stratification system and tnm staging in papillary thyroid carcinoma |
title_full_unstemmed |
The impact of ipsilateral central neck dissection on the 2015 american thyroid association risk stratification system and tnm staging in papillary thyroid carcinoma |
title_sort |
The impact of ipsilateral central neck dissection on the 2015 american thyroid association risk stratification system and tnm staging in papillary thyroid carcinoma |
author |
Gustavo Cancela e Penna |
author_facet |
Gustavo Cancela e Penna Patricia Corradi Henrique Mendes Cynthia. Berenstein Magda. Pires Bernardo Fonseca Gustavo Moraes |
author_role |
author |
author2 |
Patricia Corradi Henrique Mendes Cynthia. Berenstein Magda. Pires Bernardo Fonseca Gustavo Moraes |
author2_role |
author author author author author author |
dc.contributor.author.fl_str_mv |
Gustavo Cancela e Penna Patricia Corradi Henrique Mendes Cynthia. Berenstein Magda. Pires Bernardo Fonseca Gustavo Moraes |
dc.subject.other.pt_BR.fl_str_mv |
Tireóide Estadiamento da Neoplasia Carcinoma Papilífero Dissecção do Pescoço |
topic |
Tireóide Estadiamento da Neoplasia Carcinoma Papilífero Dissecção do Pescoço |
description |
Background: In patients with classic papillary thyroid carcinoma (PTC) and no clinical evidence of lymph node metastasis (cN0), elective central neck dissection remains controversial. This study evaluates whether elective ipsilateral central neck dissection (eICND) along with total thyroidectomy could modify the staging of these patients. Additionally, we aim to assess pN1 risk factors, the incidence of post-operative complications, and the correlation between pN1 and change in tumor classification according to the risk stratification score of the American thyroid association 2015 (ATA 2015-RSS) and the TNM Score. Methods: This is a prospective, observational study, involving 46 patients with cN0 PTC who underwent eICND along with total thyroidectomy. The number of metastatic lymph nodes, the largest lymph node metastasis, and the extra-nodal extension were assessed. Results: 22 out of 46 patients (47.8%; CI 32.9–63.1) presented lymph node metastasis. Seventeen out of the 45 patients initially classified as low or intermediate ATA 2015-RSS upgraded their risk staging (37.8%; CI 23.8–53.5). Fourteen out of these reclassified patients had their initial ATA 2015-RSS changed due to lymph node metastasis larger than 2 mm (mostly between 3 mm and 4 mm). Ten out of 46 (21.7%; CI 10.49–36.4) patients had their TNM staging reviewed. General complication rate was 17.4% (8/46). Conclusions: Elective dissection of levels VI ipsilateral and VII showed the ability to upgrade the initial ATA 2015-RSS and TNM staging in patients with cN0 PTC. However, further studies are necessary to evaluate the clinical impact of lymph node micro-metastasis. |
publishDate |
2019 |
dc.date.issued.fl_str_mv |
2019 |
dc.date.accessioned.fl_str_mv |
2022-07-28T20:53:04Z |
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2022-07-28T20:53:04Z |
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article |
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publishedVersion |
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http://hdl.handle.net/1843/43765 |
dc.identifier.doi.pt_BR.fl_str_mv |
https://dx.doi.org/10.18203/issn.2454-5929.ijohns20190754 |
dc.identifier.issn.pt_BR.fl_str_mv |
24545937 |
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https://dx.doi.org/10.18203/issn.2454-5929.ijohns20190754 http://hdl.handle.net/1843/43765 |
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24545937 |
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eng |
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International journal of otorhinolaryngology and head and neck surgery |
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Universidade Federal de Minas Gerais |
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Brasil |
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ICX - DEPARTAMENTO DE ESTATÍSTICA MED - DEPARTAMENTO DE CIRURGIA |
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Universidade Federal de Minas Gerais |
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