Title : Prognostic importance of lymphy node metastases papillary thyroid carcinoma in recurrence of disease
Background: The purpose of this study is to establish whether the lymph node metastases of the papillary thyroid carcinoma are a significant factor in recurrence of the disease by analyzing the time until recurrence of the disease and frequency of recurrence of the disease. METHODS: From 1 January 1995 until 30 June 2017, 113 patients were treated at the Public Health Institute - Hospital "Sveti Vra?evi" in Bijeljina for PTC. In all patients, surgery of the thyroid gland and/or lymph nodes of the neck was performed. Total thyroidectomy (TT) was performed in 26 patients and near-total thyroidectomy leaving <1 g thyroid tissue adjacent to the recurrent laryngeal nerve in 7 patients. TT and lymph nodes dissection were performed in 77 patients. Palliative surgery and biopsy due to locally advanced disease were performed in 3 patients.
RESULTS: In our study, 113 patients with PTC were analyzed. 90 patients experienced pure PTC (79.6%), the other 23 patients (20.4%) experienced other variants of PTC. 26 patients (23%) experienced multicentric or bilateral tumors. 86 patients (76,1%) experienced histologically verified metastases in the lymph nodes of the neck. 7 patients (6.8%) experienced distant metastases. 27 patients underwent total thyroidectomy (TT), and 7 near-total thyroidectomy. Total thyroidectomy + dissection of central and lower jugular lymph nodes with frozen section histopathology verification was performed in 86 patients (76.1%). Out of these 86 patients, in 60 patients (69.7%) metastases were verified in the lower jugular lymph nodes. A modified lymph node dissection (MRND) was also performed in these patients.
CONCLUSION: Lymph node metastases of the papillary thyroid carcinoma are a plausible prognostic factor. They are important for recurrence of the disease, but not for survival.
Keyword: Prognostic importance, papillary thyroid carcinoma, recurrence