Research Information System
Thesis Type: Expertise In Medicine
Institution Of The Thesis: Gazi Üniversitesi, Tıp Fakültesi, Turkey
Approval Date: 2020
Thesis Language: Turkish
Student: SAYGIN ALTINER
Supervisor: AHMET KARAMERCAN
Abstract:Introduction: Papillary Thyroid Carcinoma (PTC) makes 85% of all thyroid malignancies and its most important clinical feauture is regional lymph node metastasis. Recurrens of PTC is the most important factor in mortality and morbidity and the most important factor in increased recurrens risk is lymph node metastasis. The most frequent lymph node metastasis location is ipsilateral central lymph node group. Patients who have clinically central lymph node involvement require treatment with central neck dissection. There are different opinions on proflactic Central Lymph Node Dissection (pCLND) on patients who have no cervical lymph node metastasis (cN0). The aim of this study to evaluate the risk factors increasing central lymph node metastasis and to describe indications for proflactic central lymph node dissection. Materials and Method: Two hundred fifty five (255) patients diagnosed with PTC who undergone tyhroidectomy and CLND by the same surcigal team in Gazi University School of Medicine between September 2009 and September 2019 were included to the study. Patient records have been evaluated retrospectively for demographic features, subtype of the tumor, surgical margin status, tumor consisting thyroid lobe and tumor location within the lobe, focality of the tumor, lymphovascular invasion, extracapsular spread and central lymph node metastasis as parameters. Results: Mean age of subjects included the study was 38,4 [Standard Deviation (SD) 11,5)] and the median age was 36,0 (Min: 18,0- Max: 69,0). The study includes 61 (%23,9) males and 196 ( %76,1) females in total of 255 patients. According to our study, the risk of CLNM is significantly higher in patients under 45 years old compared to ones older 45 years old (p=0,016). Male sex appeared to be a significant factor in increased risk. Evaluation of tumor size showed significant increased risk of CLNM when the widest diameter of the tumor is above 9,5. Evaluation of relationship between ratio of the metastatic lymph nodes to the exicised total lymph nodes and tumor size shows that tumor size and that ratio have low-mild grade correlation. Conclucion: As a result of the analysis of the factors that may be predictive in terms of central lymph node metastasis in papillary thyroid carcinoma; the age of under 45, male gender, total tumor diameter above 10.5 mm and the largest tumor diameter above 9.5 mm determined to be the factors that significantly increase the risk of metastasis. However, increased tumor size, on the other hand, increases the incidence of metastatic lymph nodes as well as the number of metastatic lymph nodes among dissected lymph nodes. According to these findings, parameters determined in this study could be useful in anticipation of the candidates for proflactic lymph node dissection.