Preoperative Nodal US Features for Predicting Recurrence in N1b Papillary Thyroid Carcinoma
Abstract
:Simple Summary
Abstract
1. Introduction
2. Methods
2.1. Study Population
2.2. Image Analysis
2.3. Surgery and Pathologic Analysis
2.4. Postoperative Follow-Up and Recurrence
2.5. Statistics
3. Results
4. Discussion
5. Conclusions
Author Contributions
Funding
Institutional Review Board Statement
Informed Consent Statement
Data Availability Statement
Conflicts of Interest
References
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Characteristics | Non-Recurrence (n = 655) | Recurrence (n = 37) | p Value |
---|---|---|---|
Sex | 0.002 | ||
Female | 448 (68.4) | 16 (43.2) | |
Male | 207 (31.6) | 21 (56.8) | |
Age (years) | 41.70 ± 12.81 | 45.65 ± 17.58 | 0.186 |
Pathology | 0.835 | ||
Conventional | 545 (83.2) | 30 (81.1) | |
Diffuse sclerosing variant | 86 (13.1) | 6 (16.2) | |
Others | 24 (3.7) | 1 (2.7) | |
Pathologic tumor size (mm) | 15.67 ± 9.76 | 20.38 ± 10.79 | 0.005 |
TNM stage | 0.019 | ||
I | 543 (82.9) | 24 (64.9) | |
II | 111 (16.9) | 13 (35.1) | |
III | 1 (0.2) | 0 (0.0) | |
Multifocality | 0.030 | ||
No | 417 (63.7) | 17 (45.9) | |
Yes | 238 (36.3) | 20 (54.1) | |
Bilaterality | 0.004 | ||
No | 434 (66.3) | 16 (43.2) | |
Yes | 221 (33.7) | 20 (56.8) | |
Extrathyroidal extension | 0.034 | ||
No | 127 (19.4) | 2 (5.4) | |
Yes | 528 (80.6) | 35 (94.6) | |
BRAF status | 0.740 | ||
No | 75 (11.5) | 4 (10.8) | |
Yes | 242 (36.9) | 16 (43.2) | |
None | 338 (51.6) | 17 (45.9) | |
Pathologic LN size (mm) | 11.96 ± 7.40 | 18.55 ± 11.24 | <0.0001 |
Total number of harvested LNs | 47.66 ± 21.15 | 53.91 ± 25.57 | 0.152 |
Total number of metastatic LNs | 10.82 ± 8.79 | 16.49 ± 12.19 | <0.0001 |
LN Ratio | 0.23 ± 0.17 | 0.30 ± 0.14 | 0.011 |
Extranodal extension | 0.006 | ||
No | 38.6 (38.6) | 5 (13.5) | |
Yes | 344 (52.5) | 29 (78.4) | |
None | 58 (8.9) | 3 (8.1) |
Characteristics | Non-Recurrence (n = 655) | Recurrence (n = 37) | p Value |
---|---|---|---|
Tumor size | 17.29 ± 10.37 | 20.84 ± 10.79 | 0.044 |
Tumor shape | 0.628 | ||
Parallel | 310 (47.3) | 16 (43.2) | |
Nonparallel | 345 (52.7) | 21 (56.8) | |
Tumor composition | 0.651 | ||
Solid | 626 (95.6) | 35 (94.6) | |
<50% cystic | 22 (3.4) | 1 (2.7) | |
>50% cystic | 7 (1.1 | 1 (2.7) | |
Tumor echogenicity | 0.458 | ||
Hyperechogenicity | 2 (0.3) | 0 (0.0) | |
Isoechogenicity | 12 (1.8) | 1 (2.7) | |
Hypoechogenicity | 351 (53.6) | 15 (40.5) | |
Markedly hypoechogenicity | 290 (44.3) | 21 (56.8) | |
Tumor margin | 0.587 | ||
Smooth | 0 (0) | 0 (0) | |
Lobulated | 102 (15.6) | 7 (18.9) | |
Irregular | 553 (94.7) | 30 (81.1) | |
Tumor calcification | 0.651 | ||
No | 169 (25.8) | 8 (21.6) | |
Macrocalcification | 74 (11.3) | 3 (8.1) | |
Microcalcification | 412 (62.9) | 26 (70.3) | |
LN size | 13.82 ± 10.37 | 20.84 ± 10.79 | <0.0001 |
LN cystic change | 0.345 | ||
No | 472 (72.1) | 24 (64.9) | |
Yes | 183 (27.9) | 13 (35.1) | |
LN calcification | 0.696 | ||
No | 368 (56.2) | 22 (59.5) | |
Yes | 287 (43.8) | 15 (40.5) | |
LN shape | 0.933 | ||
Oval | 394 (60.2) | 22 (59.5) | |
Round/irregular | 261 (39.8) | 15 (40.5) | |
LN echogenicity | <0.0001 | ||
Hypo-/isoechogenicity | 250 (38.2) | 2 (5.4) | |
Hyperechogenicity | 405 (61.8) | 35 (94.6) |
Variables | HR (95% CI) | p Value |
---|---|---|
Sex | ||
Female | reference | |
Male | 3.007 (1.550–5.835) | 0.001 |
Age (years) | ||
<55 | reference | |
≥55 | 2.542 (1.287–5.019) | 0.007 |
US tumor size | 1.028 (1.004–1.053) | 0.024 |
Tumor shape | ||
Parallel | reference | |
Nonparallel | 1.332 (0.686–2.586) | 0.398 |
Tumor composition | ||
Not solid | reference | |
Solid | 0.828 (0.199–3.449) | 0.796 |
Tumor echogenicity | ||
Hyper-, iso-, hypoechogenicity | reference | |
Markedly hypoechogenicity | 1.566 (0.811–3.021) | 0.181 |
Tumor margin | ||
Smooth | reference | |
Lobulated/irregular | 0.000 | >0.999 |
Tumor calcification | ||
No/macrocalcification | reference | |
Microcalcification | 1.408 (0.692–2.864) | 0.345 |
LN size | 1.070 (1.045–1.095) | <0.0001 |
LN cystic change | ||
No | reference | |
Yes | 1.258 (0.629–2.516) | 0.516 |
LN calcification | ||
No | reference | |
Yes | 0.920 (0.474–1.785) | 0.805 |
LN shape | ||
Oval | reference | |
Round/irregular | 1.093 (0.563–2.122) | 0.792 |
LN echogenicity | ||
Hypo-isoechogenicity | reference | |
Hyperechogenicity | 10.855 (2.607–45.203) | 0.001 |
LN hilum | ||
No | reference | |
Yes | 4.148 (0.568–30.313) | 0.161 |
Pathologic tumor size | 1.042 (1.017–1.068) | 0.001 |
Multifocality | ||
No | reference | |
Yes | 1.979 (1.027–3.811) | 0.041 |
Bilaterality | ||
No | reference | |
Yes | 2.364 (1.225–4.564) | 0.01 |
Extrathyroidal extension | ||
No | reference | |
Yes | 4.144 (0.995–17.251) | 0.051 |
BRAF status | ||
No | reference | |
Yes | 1.288 (0.430–3.855) | 0.651 |
Pathologic LN size | 1.078 (1.044–1.113) | <0.0001 |
Total number of harvested LNs | 1.012 (1.000–1.025) | 0.060 |
Total number of metastatic LNs | 1.048 (1.023–1.074) | <0.0001 |
LN Ratio | 2.533 (1.187–5.406) | 0.016 |
Extranodal extension | ||
No | reference | |
Yes | 3.638 (1.402–9.438) | 0.008 |
Variables | Preop Model | Postop Model | Combined Model | |||
---|---|---|---|---|---|---|
HR (95% CI) | p Value | HR (95% CI) | p Value | HR (95% CI) | p Value | |
Male sex | 2.231 (1.142–4.360) | 0.019 | 2.897 (1.332–6.301) | 0.007 | 2.277 (1.131–4.586) | 0.021 |
Age ≥ 55 years | 3.066 (1.537–6.118) | 0.001 | 1.935 (0.822–4.557) | 0.131 | 3.216 (1.529–6.766) | 0.002 |
US features | ||||||
Tumor size | 1.017 (0.993–1.042) | 0.164 | 0.983 (0.937–1.032) | 0.494 | ||
LN size | 1.055 (1.027–1.027) | <0.0001 | – | 1.054 (1.024–1.085) | <0.0001 | |
LN hyperechogenicity | 8.066 (1.916–33.960) | 0.004 | 8.223 (1.689–40.046) | 0.009 | ||
Pathologic features | ||||||
Tumor size | 1.012 (0.981–1.044) | 0.460 | ||||
Multifocality | 1.238 (0.525–2.919) | 0.625 | 1.011 (0.467–2.191) | 0.977 | ||
Bilaterality | 1.560 (0.676–3.600) | 0.298 | 1.838 (0.869–3.887) | 0.111 | ||
LN size | 1.065 (1.020–1.111) | 0.004 | ||||
Total number of metastatic LNs | 1.008 (0.964–1.055) | 0.722 | 1.028 (0.988–1.069) | 0.170 | ||
LN ratio | 27.679 (1.144–669.597) | 0.041 | 2.604 (0.543–12.480) | 0.231 | ||
Extranodal extension | 1.813 (0.668–4.923) | 0.243 | 1.764 (0.665–4.685) | 0.254 |
Variables | Sensitivity (%) | Specificity (%) | PPV (%) | NPV (%) | Accuracy (%) | AUC |
---|---|---|---|---|---|---|
Male sex | 56.76 (40.80–72.72) | 68.40 (64.84–71.96) | 9.21 (5.46–12.96) | 96.55 (94.89–98.21) | 67.77 (64.29–71.25) | 0.626 (0.543–0.709) |
Age ≥ 55 years | 35.14 (19.76–50.52) | 82.90 (80.02–85.78) | 10.40 (5.05–15.75) | 95.77 (94.11–97.43) | 80.35 (77.39–83.31) | 0.590 (0.511–0.669) |
LN size | 43.24 (27.28–59.20) | 85.65 (82.97–88.33) | 14.55 (7.96–21.14) | 96.39 (94.87–97.91) | 83.38 (80.61–86.15) | 0.644 (0.562–0.726) |
LN hyperechogenicity | 94.59 (87.30–100) | 38.17 (34.45–41.89) | 7.95 (5.42–10.48) | 99.21 (98.12–100) | 41.18 (37.51–44.85) | 0.664 (0.622–0.705) |
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Eun, N.L.; Kim, J.-A.; Gweon, H.M.; Youk, J.H.; Son, E.J. Preoperative Nodal US Features for Predicting Recurrence in N1b Papillary Thyroid Carcinoma. Cancers 2022, 14, 174. https://doi.org/10.3390/cancers14010174
Eun NL, Kim J-A, Gweon HM, Youk JH, Son EJ. Preoperative Nodal US Features for Predicting Recurrence in N1b Papillary Thyroid Carcinoma. Cancers. 2022; 14(1):174. https://doi.org/10.3390/cancers14010174
Chicago/Turabian StyleEun, Na Lae, Jeong-Ah Kim, Hye Mi Gweon, Ji Hyun Youk, and Eun Ju Son. 2022. "Preoperative Nodal US Features for Predicting Recurrence in N1b Papillary Thyroid Carcinoma" Cancers 14, no. 1: 174. https://doi.org/10.3390/cancers14010174
APA StyleEun, N. L., Kim, J.-A., Gweon, H. M., Youk, J. H., & Son, E. J. (2022). Preoperative Nodal US Features for Predicting Recurrence in N1b Papillary Thyroid Carcinoma. Cancers, 14(1), 174. https://doi.org/10.3390/cancers14010174