Int J Thyroidol.  2023 Nov;16(2):157-165. 10.11106/ijt.2023.16.2.157.

Significance of Lymphovascular Invasion as a Prognostic Factor in Patients with Papillary Thyroid Cancer: a Systematic Review and Meta-Analysis

• Won HR
• Koo BS

• KMID: 2548743
• DOI: http://doi.org/10.11106/ijt.2023.16.2.157

Abstract

Conflicting research results have been reported regarding the influence of lymphovascular invasion as a prognostic factor for recurrence of papillary thyroid cancer, and thus, it is continuously discussed. This systematic review and meta-analysis identified an association between recurrence rate and histological lymphatic or vascular invasion in patients with papillary thyroid carcinoma. Clinical data and outcomes were collected from MEDLINE, Embase, the Cochrane Database of Systematic Reviews and KoreaMed. Selection criteria included studies reporting local or distant recurrence rates according to histological lymphatic or vascular invasion in patients with papillary thyroid carcinoma. Twelve observational studies were included in this study. When vascular invasion was confirmed histologically in patients with papillary thyroid cancer, the local recurrence rate was odds ratio 2.544 (95% confidence interval [CI], 1.469-4.407) compared to the patient group without vascular invasion, and the distant recurrence rate was 5.126 (95% CI, 2.853-9.212). The correlation between lymphatic invasion and recurrence rate could not be analyzed. As a result, this systematic review and meta-analysis confirmed that histological vascular invasion affects the rate of local or distant recurrence in patients with papillary thyroid cancer. Therefore, the presence of histological vascular invasion must be evaluated in patients with papillary thyroid cancer.

Keyword

Thyroid cancer; Papillary thyroid cancer; Lymphovascular invasion; Vascular invasion; Recurrence

Figure

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  Fig. 1 Risk of bias summary using RoBANS version 2.0. A: comparison possibility of participants, B: selection of participants, C: confounding variables, D: intervention (exposure) measurement, E: blinding of outcome assessment, F: outcome evaluation, G: incomplete outcome data, H: selective outcome reporting (red circle: high risk, green circle: low risk)

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  Fig. 2 PRISMA flow diagram showing the selection of studies for inclusion in the systematic review and meta-analysis.

Reference

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