![]() Therefore, the cut point of patient age to stratify the risk of LLNM has not been well established yet. However, the exact tendency of the risk ratio of LLNM as age changes is still unclear. Several studies have also reported that the risk of LLNM decreased as age increased simultaneously. It is proved that age is one of the most important prognostic factors of overall survival and disease-specific survival in PTC. Thus, constructing a precise predictive model for LLNM seems essential in improving the efficacy of operations. Previous studies reported that the incidence of occult LLNM in PTC patients could reach 18.6-64%. However, the sensitivity of evaluations, including preoperative imaging examination and intraoperative frozen pathology, is limited, and occult LNM may lead to relapse and secondary operation. The most common site of LNM in PTC is the central compartment, followed by the lateral compartment.Īccording to the latest American Thyroid Association (ATA) guidelines and National Comprehensive Cancer Network (NCCN) guidelines, lateral neck dissection (LND) is only recommended for patients who were diagnosed with lateral lymph node metastasis (LLNM) before or during the operation. As it is acknowledged that PTC has quite a low mortality rate and LNM has a less significant factor influencing survival rate, several recent studies found that LNM still negatively affected long-term recurrence. Papillary thyroid carcinoma (PTC), the most common type of thyroid malignancy, is prone to lymph node metastasis (LNM). The incidence of thyroid mass has rapidly increased in the past few decades. ![]() LND should be more actively performed when CLNM is confirmed for younger patients with tumors in the upper lobe and older patients with extra-thyroidal extension tumors, more aggressive detection of the lateral neck might be considered. Our study could be interpreted as an implication for a change in surgical management. Apart from CLNM, sex( p = 0.033), tumor size( p = 0.027), and tumor location( p = 0.020) were independent predictors for patients younger than 30 years old tumor location( p = 0.013), extra-thyroidal extension( p < 0.001), and extra-nodal extension( p = 0.042) were independent risk factors for patients older than 45 years old. Central lymph node metastasis (CLNM) was a prominent risk factor for further LNM in all patients. Younger patients were more likely to have LLNM, and the optimal cut points of age to stratify the risk of LLNM were 30 and 45 years old. Multivariate logistic regression analysis was performed to identify independent risk factors of LLNM in each group divided by age. The locally weighted scatterplot smoothing (LOWESS) curve and the ‘changepoint’ package were used to identify the optimal age cut point using R. MethodsĪ total of 499 patients who had undergone thyroidectomy and lateral neck dissection (LND) for PTC were enrolled. This study aimed to identify the optimal cut point of age for a more precise prediction model of LLNM and to reveal differences in risk factors between patients of distinct age stages. But the consultant said to me after 8 weeks with lymphoma a child would be symptomatic as they don't have slow growing cancers like adults do.Studies have revealed that age is associated with the risk of lateral lymph node metastasis (LLNM) in papillary thyroid cancer (PTC). I know how you feel, I thought I was dying from anxiety. She has also said his eczema or cradle cap might be to blame. The consultant is now saying he's obviously fought something off and now they may just stay like this. I was worried about Lymphoma, spent hours on Google and ended up off sick from work. We had an ultrasound of the nodes which we were told all measured less than 1cm so weren't even classed as enlarged, just felt raised as they've not gone back to normal size after being raised at one point and are now "shotty". Then repeat bloods were done a few days ago, they were nromal. Anyway, we got seen within 2 weeks, blood tests, showed he was fighting an infection but nothing worrying. I am a hcp so knew this wasn't right, went back for a 2nd opinion and got referred to an oncologist. Otherwise he has been healthy, no symptoms. I have been hysterical for about 4 weeks because my 1 year old has had lymph nodes up for about 8 weeks, 2 above his clavicle which is a bad sign usually, one at base of head and several in his neck.
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