Clin Exp Otorhinolaryngol.  2015 Sep;8(3):289-294. 10.3342/ceo.2015.8.3.289.

Significance of the Extracapsular Spread of Metastatic Lymph Nodes in Papillary Thyroid Carcinoma

• Park CH
• Song CM
• Ji YB
• Pyo JY
• Yi KJ
• Song YS
• Park YW
• Tae K

• KMID: 2117526
• DOI: http://doi.org/10.3342/ceo.2015.8.3.289

Abstract

OBJECTIVES
The extracapsular spread (ECS) of metastatic lymph nodes is associated with aggressive tumor behavior, and is regarded as a major risk factor for local recurrence in patients with head and neck squamous cell carcinoma. However, the significance of ECS of metastatic lymph nodes has not been well established in well-differentiated thyroid carcinoma. The purpose of this study was to examine this question.
METHODS
A retrospective review was performed of 335 patients with papillary thyroid carcinoma who underwent total thyroidectomy with lymph node dissection from April 2001 to December 2009. We analyzed various clinical characteristics, pathologic factors, and the size, number, and ECS of foci in metastatic lymph nodes.
RESULTS
On pathologic review, 201 of the patients (56.6%) had lymph node metastasis. This was significantly related to age and tumor size. ECS was noted in 64 of these 201 patients (31.8%), and was significantly related to male gender, tumor size, presence of extrathyroidal extension, metastatic lymph node size, and focus size. Recurrence occurred in 13 patients (3.9%), and the presence of ECS was significantly related to recurrence.
CONCLUSION
ECS of metastatic lymph nodes is an important prognostic factor for loco-regional recurrence in papillary thyroid carcinoma.

Keyword

Thyroid Cancer, Papillary; Metastatic Lymph Node; Extracapsular Spread

MeSH Terms

Carcinoma, Squamous Cell
Head
Humans
Lymph Node Excision
Lymph Nodes*
Male
Neck
Neoplasm Metastasis
Recurrence
Retrospective Studies
Risk Factors
Thyroid Gland*
Thyroid Neoplasms*
Thyroidectomy

Figure

• 

  Fig. 1 Pathologic findings of lymph node metastasis in papillary thyroid carcinoma (H&E, ×40). (A) Metastatic tumor foci with intact lymph node capsule. (B) Metastatic tumor foci extend to the surrounding perinodal fat tissue beyond the fibrous capsule of the lymph node.

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