The impact of thyroid tumor features on lymph node metastasis in papillary thyroid carcinoma patients in head and neck department at KAMC: A retrospective cross-sectional study

Amjad O Aljohani; Reyan H Merdad; Anas I Alserif; Layan S Alhemayed; Noor Z Farsi; Thamer A Alsufyani; Haddad H Alkaf; Ameen Z Alherabi; Sherif K Abdelmonim; Mohammad A Alessa

doi:10.1016/j.amsu.2021.102217

The impact of thyroid tumor features on lymph node metastasis in papillary thyroid carcinoma patients in head and neck department at KAMC: A retrospective cross-sectional study

Ann Med Surg (Lond). 2021 Mar 22:64:102217. doi: 10.1016/j.amsu.2021.102217. eCollection 2021 Apr.

Authors

Affiliations

¹ Al-Farabi Private College for Dentistry and Nursing, Jeddah, Saudi Arabia.
² College of Medicine, King Saud Bin Abdulaziz University for Health Sciences, Jeddah, Saudi Arabia.
³ Faculty of Medicine, King Abdulaziz University, Jeddah, Saudi Arabia.
⁴ Umm Al-Qura University, Makkah, Saudi Arabia.
⁵ Taif University, Taif, Saudi Arabia.
⁶ Department of Head and Neck Surgery, Head and Neck and Skull Base Health Center, King Abdullah Medical City, Makkah, Saudi Arabia.
⁷ Department of Otolaryngology-Head & Neck Surgery, College of Medicine, Umm Al-Qura University, Saudi Arabia.
⁸ Department of Otolaryngology Head and Neck Surgery, Faculty of Medicine, Ain Shams University, Cairo, Egypt.

Abstract

Papillary thyroid carcinoma (PTC) is the most prevalent type of thyroid cancer. It is one of the most common types of malignancy of the thyroid that spreads to cervical lymph nodes. Lymph node metastasis (LNM) is an important factor when determining recurrence risk, and determining the extent of lymph node involvement can guide treatment. Our main objective is to evaluate the association between the size of the tumor and the number of lymph node metastases in patients with PTC.

Methods: We conducted an electronic retrospective chart review of 125 patients with PTC followed in the Head and Neck Department at KAMC from 2009 to 2020. Twenty-two patients included in our study were pathologically and clinically diagnosed and confirmed to have LNM of PTC.

Results: The study included 22 PTC patients who had undergone lymph node dissections. Patients had a median age of 38.8 years (IQR = 32.2-54.5), and the median tumor size was 20.5 mm. The most commonly affected level of the neck was IV (76.2%). Distant metastasis M1 was seen in only two patients (9.1%). Tumors sizes >30mm (75%) had ≥5 LNM. Most cases were the classic subtype PTC. For the site of the tumor, the site had a significant impact on the number of LNM (p = 0.004). Multifocality had a high impact on LNM (p = 0.019).

Conclusions: This study showed no association between the size of PTC and the number of LNMs. The bilaterality of PTC was significantly associated with a high number of LNMs.

Keywords: Lymph node metastasis; Neck dissection; Papillary thyroid carcinoma; Thyroid cancer; Thyroid in Saudi Arabia.