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. 2021 Sep 16:11:657237.
doi: 10.3389/fonc.2021.657237. eCollection 2021.

The Differences Between Multifocal and Unifocal Papillary Thyroid Carcinoma in Unilateral Lobe: A Meta-Analysis

Ting Zhang  1 , Liang He  1 , Zhihong Wang  1 , Wenwu Dong  1 , Wei Sun  1 , Ping Zhang  1 , Hao Zhang  1
Affiliations

The Differences Between Multifocal and Unifocal Papillary Thyroid Carcinoma in Unilateral Lobe: A Meta-Analysis

Ting Zhang et al. Front Oncol. .

Abstract

Background: As many inconsistent reports on the clinical manifestations and prognosis between unilateral unifocal PTC (UUPTC) and unilateral multifocal PTC (UMPTC), identifying the difference should guide management. The purpose of this study was to investigate other additional differences between UUPTC and UMPTC in addition to their difference in the number of cancer foci.

Data sources: A systematic literature search was conducted in the PubMed and Web of Science databases for relevant studies published before December 31, 2020. Their reference lists were also reviewed.

Review methods: Two reviewers independently extracted data and assessed the quality of eligible studies. Studies on patients who underwent an open thyroidectomy with or without neck dissection were included. Data were analyzed using the RevMan 5.3 software.

Results: Fifteen studies comprising 9,665 patients were selected for the meta-analysis. UMPTC occurred in 10% to 36% of all PTC cases. There were no significant differences between UMPTC and UUPTC patients in age, gender, tumor size, and extrathyroidal extension (ETE). However, significant differences (P < 0.05) between UMPTC and UUPTC patients were observed in central lymph node metastasis (CLNM), lateral lymph node metastasis (LLNM), tumor-node-metastasis (TNM) stage I+II, TNM stage III+IV, the recurrence/persistence of the UMPTC group after total thyroidectomy and overall recurrence/persistence.

Conclusion: UMPTC patients are more likely to have CLNM, LLNM, more advanced TNM stage, and recurrence/persistence than UUPTC patients. Compared with UUPTC, UMPTC patients should undergo central lymph node dissection, and pay more attention to LLNM, TNM stage and recurrence/persistence during the follow-up.

Keywords: central lymph node metastasis; lateral lymph node metastasis; recurrence/persistence; tumor-node-metastasis stage; unilateral multifocal PTC; unilateral unifocal PTC.

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Conflict of interest statement

The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest.

Figures

Figure 1
Figure 1
Flowchart of study selection.
Figure 2
Figure 2
Meta-analysis results for the difference between the UMPTC and UUPTC. (A) Age; (B) Female; (C) Male.
Figure 3
Figure 3
Meta-analysis results for the difference between the UMPTC and UUPTC. (A) Size; (B) ETE; (C) CLNM.
Figure 4
Figure 4
Meta-analysis results for the difference between the UMPTC and UUPTC. (A) LLNM; (B) TNM stage I+II; (C) TNM stage III+IV.
Figure 5
Figure 5
Meta-analysis results for the difference between the UMPTC and UUPTC. (A) Overall recurrence/persistence; (B) The recurrence/persistence after total thyroidectomy.
See this image and copyright information in PMC

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