Association between lymph node metastasis and patients

Hye-Seon Oh; Min Ji Jeon; Suyeon Park; Mijin Kim; Hyemi Kwon; Eyun Song; Won Gu Kim; Young Kee Shong; Won Bae Kim; Tae Yong Kim

doi:10.1530/endoabs.49.EP1367

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Endocrine Abstracts (2017) 49 EP1367 | DOI: 10.1530/endoabs.49.EP1367

ECE2017 Eposter Presentations: Thyroid Thyroid (non-cancer) (260 abstracts)

Association between lymph node metastasis and patients’ age in papillary thyroid microcarcinoma

Hye-Seon Oh , Min Ji Jeon , Suyeon Park , Mijin Kim , Hyemi Kwon , Eyun Song , Won Gu Kim , Young Kee Shong , Won Bae Kim & Tae Yong Kim

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Internal Medicine, Asan Medical Center, Seoul, Republic of Korea.

Background: Recent studies presented that younger patients with papillary thyroid microcarcinoma (PTMC) had poorer clinical outcomes compared to older PTMC patients. The aim of this study is to investigate the impact of patient’s age on the lymph node metastasis (LNM) status of PTMC, a risk factor for recurrence and poor clinical outcome of PTMC.

Methods: The study evaluated 2068 PTMC patients who underwent thyroid operation with lymph node (LN) dissection from 2001 to 2009. All patients were allocated into five groups by age; Group A (≤35 years), Group B (35 <age≤45), Group C (45<age≤55), Group D (55<age≤65), and Group E (65<age). LNM status was divided into three groups by the number of metastatic LNs: no LNM, low volume LNM (≤5 metastatic LNs), high volume LNM (>5 metastatic LNs). We evaluated the correlation between patient’s age and high volume LNM in this study.

Results: High volume LNM was found in 199 (8.9%) patients among whole study subjects and was the most frequently found in the young age group (A 17.3%, B 8.4%, C 7.2%, D 8.4%, and E 7.1%, respectively). Young age (Group A), male gender, larger primary tumor (>0.5 cm), multifocality, and extrathyroidal extensions were significant risk factors for high volume LNM in univariate and multivariate analysis. In multivariate analysis, odd ratio (OR) of Group A for high volume LNM was 3.49 (95% CI, 1.67–8.06; P-value 0.002) compared to the Group E. When analyzed only in women, young age (Group A) was also a significant risk factor for high volume LNM (OR 6.00, 95% CI 2.73–20.76, P value 0.001). But when analyzed in men, there was no significant difference in the incidence of high volume LNM by different age groups (A 25%, B 18.1%, C 20.2%, D 22.0%, and E 22.7%, respectively).

Conclusion: High volume LNM was more frequently found in young aged female and male patients. For patients under 35 years or male patients, immediate diagnosis and surgical treatment for PTMC might be needed.