CLINICAL AND IMAGING CHARACTERISTICS, TNM STAGING OF PATIENTS WITH CERVICAL LYMPH NODE METASTASES IN PAPILLARY THYROID CANCER AT CAN THO ONCOLOGY HOSPITAL

Abstract

Background: Thyroid carcinomas are the most common endocrine malignancies. The cervical lymph node metastasis rate in patients with PTC ranges from 30-80% and there is a significant difference in survival at 14 years for those with and without lymph node metastases. Therefore, the early detection of metastatic cervical lymph nodes plays an essential role in deciding upon the optimal surgical treatment plan for the majority of patients, which will allow careful postoperative screening, adjuvant therapies, and minimizes the chance of disease recurrence, so we conducted this study. Objectives: To evaluate clinical and imaging characteristics, TNM staging of papillary thyroid carcinoma patients with cervical lymph node metastases at Can Tho Oncology Hospital between 2021 and 2023. Materials and methods: This was a descriptive cross-sectional study, including 52 patients who underwent total thyroidectomy and therapeutic neck dissection. Evaluating general characteristics such as age, gender, reasons for encounter, thyroid nodule and cervical lymph node characteristics on clinical examination and imaging, cancer staging. Results: The average age was 40.0 ± 14.1 years (range 13 - 71). The female/male ratio was 2.5:1. The most common age group was <55 years (86.5%). Half of the patients (50%) were admitted to our institute due to palpable neck mass. The proportion of palpable nodules on clinical examination was three quarters. Nodule locating in a single lobe was the dominant characteristic (about 90%). The TIRADS classifications were TIRADS 5 (55.8%), TIRADS 4 (40.4%) and TIRADS 3 (3.8%). The common location of metastatic cervical lymph node was lateral compartment (86.6%). The absence of central hilar structure shown on ultrasound was 94.2%. Stage I thyroid cancer had the highest rate (84.6%). Conclusions: The presence of nodules in a single lobe was the most notable characteristic of thyroid cancer. TIRADS 4 and 5 were shown on ultrasonography in the majority of patients. The lateral compartment was the most common location for metastatic cervical lymph nodes, while the central hilar structure of those nodes mostly absent.