title: Lymph node characteristics for predicting locoregional recurrence of papillary thyroid cancer in adolescents and young adults.
abstract: To determine lymph node (LN) characteristics predictive of locoregional recurrence (LRR) in adolescent and young adult (AYA) ages 15-39years presenting with papillary thyroid cancer (PTC) and cervical pathologically proven LN metastases (pN1).
  
  
  
  Retrospective chart review was performed for all patients with PTC and nodal metastases who had undergone total thyroidectomy, LN dissection, and postoperative radioactive iodine therapy in a university hospital between 2006 and 2014. Clinical and histopathologic markers that were independently associated with tumor recurrence were evaluated.
  
  
  
  In all, 329 consecutive AYA patients were included. At a median follow-up of 57months, twenty patients (6.08%) experienced LRR. No patients had distant metastases, and no patients died during follow-up. Based on Cox regression analysis, the presence of extranodal extension and more than six metastatic LNs at presentation were independent predictive factors for LRR. However, age, male sex, total number of LNs resected, pN1b, LN ratio, size of the largest metastatic LN, extrathyroidal extension, tumor size, bilateral tumor, multifocality, vascular invasion, and Hashimoto thyroiditis were not correlated with an increased risk for LRR. A cutoff of more than six positive nodes optimally predicted future LRR with sensitivity and specificity values of 85.0% and 60.2%, respectively.
  
  
  
  The presence of extranodal extension and more than six metastatic LNs were independent predictors of LRR in AYA patients with pN1 disease. Evaluation of these prognostic factors appears to help identify patients who require close monitoring.
authors.affiliation: Deparment of Nuclear Medicine, Zhujiang Hospital of Southern Medical University, 253 Gongye Road, Guangzhou, Guangdong Province, China. Electronic address: yungangsun@foxmail.com.
authors.forename: Yungang
authors.initials: Y
authors.lastname: Sun
authors.affiliation: Department of Pharmaceutical Sciences, Sun Yat-sen Memorial Hospital, Sun Yat-sen University, 107 Yan Jiang West Road, Guangzhou, Guangdong Province, China. Electronic address: sunsince2013@sina.com.
authors.forename: Xiang
authors.initials: X
authors.lastname: Liu
authors.affiliation: Deparment of Nuclear Medicine, Zhujiang Hospital of Southern Medical University, 253 Gongye Road, Guangzhou, Guangdong Province, China. Electronic address: oyw1963@sina.com.
authors.forename: Wei
authors.initials: W
authors.lastname: Ouyang
authors.affiliation: Deparment of Nuclear Medicine, Zhujiang Hospital of Southern Medical University, 253 Gongye Road, Guangzhou, Guangdong Province, China. Electronic address: fhj0403@126.com.
authors.forename: Huijuan
authors.initials: H
authors.lastname: Feng
authors.affiliation: Deparment of Nuclear Medicine, Zhujiang Hospital of Southern Medical University, 253 Gongye Road, Guangzhou, Guangdong Province, China. Electronic address: wu_juqing@126.com.
authors.forename: Juqing
authors.initials: J
authors.lastname: Wu
authors.affiliation: Deparment of Nuclear Medicine, Zhujiang Hospital of Southern Medical University, 253 Gongye Road, Guangzhou, Guangdong Province, China. Electronic address: chenpan1211@126.com.
authors.forename: Pan
authors.initials: P
authors.lastname: Chen
authors.affiliation: Deparment of Nuclear Medicine, Zhujiang Hospital of Southern Medical University, 253 Gongye Road, Guangzhou, Guangdong Province, China. Electronic address: 642593927@qq.com.
authors.forename: Jing
authors.initials: J
authors.lastname: Wang
mesh_terms: D000293:Adolescent; D000328:Adult; D002291:Carcinoma, Papillary / Q000473:pathology*; D005260:Female; D006801:Humans; D008198:Lymph Nodes / Q000473:pathology*; D008207:Lymphatic Metastasis; D008297:Male; D009364:Neoplasm Recurrence, Local; D000077273:Thyroid Cancer, Papillary; D013964:Thyroid Neoplasms / Q000473:pathology*; D055815:Young Adult
keywords: Adolescents; Locoregional recurrence; Lymph node; Papillary thyroid cancer; Prognosis; Young adults