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A Model Predicting Occult Metastases in Lateral Lymph Nodes in pN1a Stage Papillary Thyroid Cancer

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Názov: A Model Predicting Occult Metastases in Lateral Lymph Nodes in pN1a Stage Papillary Thyroid Cancer
Autori: Chen,Yan, Chen,Shaohua, Mei,Yujia, Wang,Fengwei, Wei,Teng, Wei,Changyuan
Informácie o vydavateľovi: Dove Press 2025-08-06
Druh dokumentu: Electronic Resource
Abstrakt: Yan Chen,1,2,* Shaohua Chen,2,* Yujia Mei,3 Fengwei Wang,4 Teng Wei,2 Changyuan Wei1 1Department of Breast and Thyroid Surgery, Guangxi Medical University Cancer Hospital, Nanning, Guangxi, People’s Republic of China; 2Department of Breast and Thyroid Surgery, Liuzhou People’s Hospital Affiliated to Guangxi Medical University, Liuzhou, Guangxi, People’s Republic of China; 3Department of Neurology, The Second Affiliated Hospital of Guangxi Medical University, Nanning, Guangxi, People’s Republic of China; 4Health Management Centre, Liuzhou People’s Hospital Affiliated to Guangxi Medical University, Liuzhou, Guangxi, People’s Republic of China*These authors contributed equally to this workCorrespondence: Changyuan Wei, Email changyuanwei@gxmu.edu.cnObjective: This study aimed to develop and validate a nomogram for predicting occult lateral neck lymph node metastasis (LLNM) in patients with pN1a papillary thyroid carcinoma (PTC), addressing the clinical controversy surrounding prophylactic lateral neck dissection (PLND).Methods: A retrospective analysis was conducted on 128 pN1a PTC patients who underwent total thyroidectomy with bilateral central lymph node dissection and ipsilateral PLND between 2020 and 2023. Clinical and pathological data, including tumor location, size, capsular invasion, and nodal status, were collected. Least Absolute Shrinkage and Selection Operator (LASSO) regression and multivariate logistic regression were employed to identify independent risk factors for lymph node metastasis (LNM). A nomogram was constructed based on these factors and internally validated using bootstrap resampling (B=1000). External validation was performed on an additional 37 patients treated between 2023 and 2024.Results: Tumor location in the upper pole (odds ratio [OR]: 2.45), size > 10 mm (OR: 2.12), and capsular invasion (OR: 1.89) were identified as independent predictors of occult LLNM. The nomogram demonstrated robust discrim
Témy: International Journal of General Medicine, Original Research, info:eu-repo/semantics/article
URL: https://www.dovepress.com/a-model-predicting-occult-metastases-in-lateral-lymph-nodes-in-pn1a-st-peer-reviewed-fulltext-article-IJGM
info:eu-repo/semantics/altIdentifier/doi/10.2147/IJGM.S528876
Dostupnosť: Open access content. Open access content
info:eu-repo/semantics/openAccess
Poznámka: text/html
English
Other Numbers: NZDMP oai:dovepress.com/105501
1532813983
Prispievajúcí zdroj: DOVE MEDL PRESS LTD
From OAIster®, provided by the OCLC Cooperative.
Prístupové číslo: edsoai.on1532813983
Databáza: OAIster
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Abstrakt:Yan Chen,1,2,* Shaohua Chen,2,* Yujia Mei,3 Fengwei Wang,4 Teng Wei,2 Changyuan Wei1 1Department of Breast and Thyroid Surgery, Guangxi Medical University Cancer Hospital, Nanning, Guangxi, People’s Republic of China; 2Department of Breast and Thyroid Surgery, Liuzhou People’s Hospital Affiliated to Guangxi Medical University, Liuzhou, Guangxi, People’s Republic of China; 3Department of Neurology, The Second Affiliated Hospital of Guangxi Medical University, Nanning, Guangxi, People’s Republic of China; 4Health Management Centre, Liuzhou People’s Hospital Affiliated to Guangxi Medical University, Liuzhou, Guangxi, People’s Republic of China*These authors contributed equally to this workCorrespondence: Changyuan Wei, Email changyuanwei@gxmu.edu.cnObjective: This study aimed to develop and validate a nomogram for predicting occult lateral neck lymph node metastasis (LLNM) in patients with pN1a papillary thyroid carcinoma (PTC), addressing the clinical controversy surrounding prophylactic lateral neck dissection (PLND).Methods: A retrospective analysis was conducted on 128 pN1a PTC patients who underwent total thyroidectomy with bilateral central lymph node dissection and ipsilateral PLND between 2020 and 2023. Clinical and pathological data, including tumor location, size, capsular invasion, and nodal status, were collected. Least Absolute Shrinkage and Selection Operator (LASSO) regression and multivariate logistic regression were employed to identify independent risk factors for lymph node metastasis (LNM). A nomogram was constructed based on these factors and internally validated using bootstrap resampling (B=1000). External validation was performed on an additional 37 patients treated between 2023 and 2024.Results: Tumor location in the upper pole (odds ratio [OR]: 2.45), size > 10 mm (OR: 2.12), and capsular invasion (OR: 1.89) were identified as independent predictors of occult LLNM. The nomogram demonstrated robust discrim