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. 2015 Sep;8(3):289-94.
doi: 10.3342/ceo.2015.8.3.289. Epub 2015 Aug 13.

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

Chang Ho Park  1 , Chang Myeon Song  1 , Yong Bae Ji  1 , Ju Yeon Pyo  2 , Ki Jong Yi  2 , Young Soo Song  2 , Yong Wook Park  2 , Kyung Tae  1
Affiliations

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

Chang Ho Park et al. Clin Exp Otorhinolaryngol. 2015 Sep.

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.

Keywords: Extracapsular Spread; Metastatic Lymph Node; Thyroid Cancer, Papillary.

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Conflict of interest statement

CONFLICT OF INTEREST: No potential conflict of interest relevant to this article was reported.

Figures

Fig. 1
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.
See this image and copyright information in PMC

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