Abstract
PurposeTo investigate the prognostic significance of extranodal extension (ENE) in papillary thyroid cancer (PTC).MethodsSeven hundred forty-three PTC patients were enrolled in the study from January 2014 to December 2017. The patients were dichotomized according to the presence of ENE. Logistic analysis was used to compare differences between the two groups. Kaplan–Meier (K-M) curve and propensity score matching (PSM) analyses were used for recurrence-free survival (RFS) comparisons. Cox regression was performed to analyze the effects of ENE on RFS in PTC.ResultsThirty-four patients (4.58%) had ENE. Univariate analysis showed that age, tumor size, extrathyroidal extension, and nodal stage were associated with ENE. Further logistic regression analysis showed that age, extrathyroidal extension, and nodal stage remained statistically significant. Evaluation of K-M curves showed a statistically significant difference between the two groups before and after PSM. Cox regression showed that tumor size and ENE were independent risk factors for RFS.ConclusionsAge ≥55 years, extrathyroidal extension, and lateral cervical lymph node metastasis were identified as independent risk factors for ENE. ENE is an independent prognostic factor in PTC.
Highlights
With the rapid development of medical technology, the demand for evidence-based clinical practice and decision-making has progressively increased
Patients were selected according to the following inclusion criteria: 1) papillary thyroid carcinoma (PTC) and cervical lymph node metastasis were confirmed by pathologic examination and Follow-Up Strategy for Papillary Thyroid Carcinoma Patients
Univariate analysis showed that age, tumor size, extrathyroidal extension, and nodal stage were associated with extranodal extension (ENE), whereas sex, multifocality, and Hashimoto’s thyroiditis were not
Summary
With the rapid development of medical technology, the demand for evidence-based clinical practice and decision-making has progressively increased. In previous studies on PTC, approximately 20%–80% of patients have cervical lymph node metastasis when diagnosed [3, 4]. PTC has an indolent clinical course despite the high incidence of lymph node metastasis. The prognosis of lymph node metastasis in PTC patients remains controversial [5]. When PTC develops lymph node metastasis, some metastatic cancers may break through the node capsule into neighboring tissue and metastasize to regional organs, which is called extranodal extension (ENE) [6]. Some scholars have pointed out that invasive ENE does not affect the survival of PTC patients [8]
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