title: The prognostic value of regional lymph node metastases in patients of Guangdong Province, China with differentiated thyroid cancer: A multicenter retrospective clinical study.
abstract: Although the prognostic value of nodal metastases in differentiated thyroid cancer remains controversial, it is of interest to evaluate and understand the different characteristics of predictive outcomes.A multicenter retrospective study was conducted in 215 untreated patients with differentiated thyroid cancer from July 1997 to July 2015 in 4 medical centers of Guangdong Province. A total of 107 patients with nodal metastases (group A) were compared to 108 patients without metastases (group B). The 5-year disease-free survival (DFS), overall survival (OS), and postoperative complications in both groups were calculated. Variables predictive of DFS and OS were evaluated in group A.The group A had lower 5-year DFS (69.16%, 11 months) and shorter median time of recurrence than those in group B (87.96%, 8.5 months, respectively, P < 0.001). The incidence of temporary hypoparathyroidism in group A is lower; whereas higher incidence of temporary unilateral vocal cord palsy, permanent hypoparathyroidism, permanent unilateral vocal cord palsy, and bilateral vocal cord palsy in group A were observed. Both univariate and multivariate analyses in group A revealed that age, pathological tumor node metastasis (pTNM) stage, and histology were related to DFS (P < 0.05); while pTNM stage and histology were related to OS only in univariate analyses.Positive nodal metastases have significant prognostic value in patients with differentiated thyroid cancer in Guangdong, China and primarily reduce DFS. Moreover, patients with positive nodal metastases who are >45 years and have higher pTNM stage or follicular histology tend to have poor prognosis. Selective lymph node dissection with appropriate postoperative treatment and frequent follow-up should be accorded to these vulnerable groups of patients.
authors.affiliation: Department of General surgery, Zhujiang Hospital, Southern Medical University, Guangzhou, Guangdong Province, China Nanfang Hospital, Southern Medical University, Guangzhou, Guangdong Province, China General Hospital of Guangzhou Military Command of PLA Guangdong No. 2 Provincial People's Hospital, Guangzhou, Guangdong Province, China.
authors.forename: Lin-Yun
authors.initials: LY
authors.lastname: He
authors.forename: Wei-Wei
authors.initials: WW
authors.lastname: Wang
authors.forename: Balde Alpha
authors.initials: BA
authors.lastname: Ibrahima
authors.forename: Shuai
authors.initials: S
authors.lastname: Han
authors.forename: Zhou
authors.initials: Z
authors.lastname: Li
authors.forename: Zhai
authors.initials: Z
authors.lastname: Cai
authors.forename: Miao-Liang
authors.initials: ML
authors.lastname: Chen
authors.forename: Bao-Zhu
authors.initials: BZ
authors.lastname: Chen
authors.forename: Hui-Shi
authors.initials: HS
authors.lastname: Tan
authors.forename: Hai-Shan
authors.initials: HS
authors.lastname: Zeng
authors.forename: Xiao-Li
authors.initials: XL
authors.lastname: Dai
authors.forename: Min-Wei
authors.initials: MW
authors.lastname: Zhou
authors.forename: Gang-Qing
authors.initials: GQ
authors.lastname: Zhang
authors.forename: Guo-Xin
authors.initials: GX
authors.lastname: Li
mesh_terms: D018263:Adenocarcinoma, Follicular / Q000175:diagnosis / Q000556:secondary* / Q000601:surgery; D000328:Adult; D002291:Carcinoma, Papillary / Q000175:diagnosis / Q000556:secondary* / Q000601:surgery; D002681:China / Q000453:epidemiology; D018572:Disease-Free Survival; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D015994:Incidence; D008198:Lymph Nodes / Q000000981:diagnostic imaging; D008207:Lymphatic Metastasis; D008297:Male; D037981:Neck Dissection / Q000379:methods*; D009364:Neoplasm Recurrence, Local / Q000453:epidemiology; D011379:Prognosis; D012189:Retrospective Studies; D013964:Thyroid Neoplasms / Q000473:pathology* / Q000601:surgery; D013965:Thyroidectomy