Survival Implications of Cervical Lymphadenectomy in Patients with Medullary Thyroid Cancer
Background The relationship between extent of cervical lymphadenectomy along with the number of involved lymph nodes (LNs) removed and overall survival has not been well documented in patients with medullary thyroid carcinoma (MTC). This study investigates whether the overall number of LNs removed a...
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| Veröffentlicht in: | Annals of surgical oncology 2011-04, Vol.18 (4), p.1028-1034 |
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| creator | Kandil, Emad Gilson, Marta M. Alabbas, Haytham H. Tufaro, Anthony P. Dackiw, Alan Tufano, Ralph P. |
| description | Background
The relationship between extent of cervical lymphadenectomy along with the number of involved lymph nodes (LNs) removed and overall survival has not been well documented in patients with medullary thyroid carcinoma (MTC). This study investigates whether the overall number of LNs removed and the number of metastatic LNs are independent prognostic factors for overall survival.
Methods
Data from patients with MTC in the Surveillance, Epidemiology, and End Results (SEER) registry database were examined. After categorizing the study population based on the number of overall LNs examined and the number of metastatic LNs, survival estimates were compared. The total number of examined LNs and their histopathological status were analyzed for their prognostic value in estimating overall survival.
Results
593 patients were included in this study. Those with all negative LNs had the best overall survival; those with LNs examined and at least one positive LN had worst overall survival (
p
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| doi_str_mv | 10.1245/s10434-010-1363-y |
| format | Article |
| fullrecord | <record><control><sourceid>proquest_cross</sourceid><recordid>TN_cdi_proquest_miscellaneous_856768369</recordid><sourceformat>XML</sourceformat><sourcesystem>PC</sourcesystem><sourcerecordid>2287935281</sourcerecordid><originalsourceid>FETCH-LOGICAL-c370t-fe9b855739ef9efb3010bdf5f1224dba467d4b22271f4d8e74666e51266715c93</originalsourceid><addsrcrecordid>eNp1kElLxEAQhRtRnHH5AV6k8eIp2nsnRwkuAyMKjicPIUvFyZDN7mQk_94OGRUEoaGX-t7rqofQGSVXlAl5bSkRXHiEEo9yxb1hD82pdC9C-XTfnYnyvYApOUNH1m4IoZoTeYhmzAkVU8Ecvb30Zlts4xIvqrYs0rgrmtriJschuELqCsuhatdxBjWkXVMNuKjxs8Og7iz-LLo1foSsL8vYDHi1HkxTZDiM6xTMCTrI49LC6W4_Rq93t6vwwVs-3S_Cm6WXck06L4cg8aXUPIDcrYS7eZIslzllTGRJLJTORMIY0zQXmQ9aKKVAUqaUpjIN-DG6nHxb03z0YLuoKmwKrqUamt5GvlRa-VyN5MUfctP0pnbNjRDVimniIDpBqWmsNZBHrSkqN15ESTTmHk25R2S8u9yjwWnOd8Z9UkH2o_gO2gFsAqwr1e9gfn_-3_ULuUaOIw</addsrcrecordid><sourcetype>Aggregation Database</sourcetype><iscdi>true</iscdi><recordtype>article</recordtype><pqid>856176270</pqid></control><display><type>article</type><title>Survival Implications of Cervical Lymphadenectomy in Patients with Medullary Thyroid Cancer</title><source>MEDLINE</source><source>SpringerLink Journals</source><creator>Kandil, Emad ; Gilson, Marta M. ; Alabbas, Haytham H. ; Tufaro, Anthony P. ; Dackiw, Alan ; Tufano, Ralph P.</creator><creatorcontrib>Kandil, Emad ; Gilson, Marta M. ; Alabbas, Haytham H. ; Tufaro, Anthony P. ; Dackiw, Alan ; Tufano, Ralph P.</creatorcontrib><description>Background
The relationship between extent of cervical lymphadenectomy along with the number of involved lymph nodes (LNs) removed and overall survival has not been well documented in patients with medullary thyroid carcinoma (MTC). This study investigates whether the overall number of LNs removed and the number of metastatic LNs are independent prognostic factors for overall survival.
Methods
Data from patients with MTC in the Surveillance, Epidemiology, and End Results (SEER) registry database were examined. After categorizing the study population based on the number of overall LNs examined and the number of metastatic LNs, survival estimates were compared. The total number of examined LNs and their histopathological status were analyzed for their prognostic value in estimating overall survival.
Results
593 patients were included in this study. Those with all negative LNs had the best overall survival; those with LNs examined and at least one positive LN had worst overall survival (
p
< 0.0001). The total number of examined LNs for both groups with negative and positive LNs was not associated with improved survival outcome (
p
= 0.41). In node-positive patients, each additional positive LN was significantly associated with an increase in overall mortality [hazard ratio (HR) = 1.05, 95% confidence interval (CI) = 1.02–1.08].
Conclusions
Cervical LN metastases conferred an independent risk for worse survival rate in MTC. Cervical lymphadenectomy is important for staging and regional disease control, however the extent of lymph node dissection, the overall number of lymph nodes removed along with removal of an increased number of involved lymph nodes do not confer a survival advantage. Future prospective studies are needed.</description><identifier>ISSN: 1068-9265</identifier><identifier>EISSN: 1534-4681</identifier><identifier>DOI: 10.1245/s10434-010-1363-y</identifier><identifier>PMID: 21046269</identifier><language>eng</language><publisher>New York: Springer-Verlag</publisher><subject>Adolescent ; Adult ; Aged ; Aged, 80 and over ; Carcinoma, Medullary - mortality ; Carcinoma, Medullary - pathology ; Carcinoma, Medullary - surgery ; Child ; Endocrine Tumors ; Female ; Follow-Up Studies ; Humans ; Lymph Node Excision ; Lymphatic Metastasis ; Male ; Medicine ; Medicine & Public Health ; Middle Aged ; Neoplasm Staging ; Oncology ; Retrospective Studies ; SEER Program ; Surgery ; Surgical Oncology ; Survival Rate ; Thyroid Neoplasms - mortality ; Thyroid Neoplasms - pathology ; Thyroid Neoplasms - surgery ; Treatment Outcome ; Young Adult</subject><ispartof>Annals of surgical oncology, 2011-04, Vol.18 (4), p.1028-1034</ispartof><rights>Society of Surgical Oncology 2010</rights><rights>Society of Surgical Oncology 2011</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c370t-fe9b855739ef9efb3010bdf5f1224dba467d4b22271f4d8e74666e51266715c93</citedby><cites>FETCH-LOGICAL-c370t-fe9b855739ef9efb3010bdf5f1224dba467d4b22271f4d8e74666e51266715c93</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://link.springer.com/content/pdf/10.1245/s10434-010-1363-y$$EPDF$$P50$$Gspringer$$H</linktopdf><linktohtml>$$Uhttps://link.springer.com/10.1245/s10434-010-1363-y$$EHTML$$P50$$Gspringer$$H</linktohtml><link.rule.ids>314,776,780,27901,27902,41464,42533,51294</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/21046269$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Kandil, Emad</creatorcontrib><creatorcontrib>Gilson, Marta M.</creatorcontrib><creatorcontrib>Alabbas, Haytham H.</creatorcontrib><creatorcontrib>Tufaro, Anthony P.</creatorcontrib><creatorcontrib>Dackiw, Alan</creatorcontrib><creatorcontrib>Tufano, Ralph P.</creatorcontrib><title>Survival Implications of Cervical Lymphadenectomy in Patients with Medullary Thyroid Cancer</title><title>Annals of surgical oncology</title><addtitle>Ann Surg Oncol</addtitle><addtitle>Ann Surg Oncol</addtitle><description>Background
The relationship between extent of cervical lymphadenectomy along with the number of involved lymph nodes (LNs) removed and overall survival has not been well documented in patients with medullary thyroid carcinoma (MTC). This study investigates whether the overall number of LNs removed and the number of metastatic LNs are independent prognostic factors for overall survival.
Methods
Data from patients with MTC in the Surveillance, Epidemiology, and End Results (SEER) registry database were examined. After categorizing the study population based on the number of overall LNs examined and the number of metastatic LNs, survival estimates were compared. The total number of examined LNs and their histopathological status were analyzed for their prognostic value in estimating overall survival.
Results
593 patients were included in this study. Those with all negative LNs had the best overall survival; those with LNs examined and at least one positive LN had worst overall survival (
p
< 0.0001). The total number of examined LNs for both groups with negative and positive LNs was not associated with improved survival outcome (
p
= 0.41). In node-positive patients, each additional positive LN was significantly associated with an increase in overall mortality [hazard ratio (HR) = 1.05, 95% confidence interval (CI) = 1.02–1.08].
Conclusions
Cervical LN metastases conferred an independent risk for worse survival rate in MTC. Cervical lymphadenectomy is important for staging and regional disease control, however the extent of lymph node dissection, the overall number of lymph nodes removed along with removal of an increased number of involved lymph nodes do not confer a survival advantage. Future prospective studies are needed.</description><subject>Adolescent</subject><subject>Adult</subject><subject>Aged</subject><subject>Aged, 80 and over</subject><subject>Carcinoma, Medullary - mortality</subject><subject>Carcinoma, Medullary - pathology</subject><subject>Carcinoma, Medullary - surgery</subject><subject>Child</subject><subject>Endocrine Tumors</subject><subject>Female</subject><subject>Follow-Up Studies</subject><subject>Humans</subject><subject>Lymph Node Excision</subject><subject>Lymphatic Metastasis</subject><subject>Male</subject><subject>Medicine</subject><subject>Medicine & Public Health</subject><subject>Middle Aged</subject><subject>Neoplasm Staging</subject><subject>Oncology</subject><subject>Retrospective Studies</subject><subject>SEER Program</subject><subject>Surgery</subject><subject>Surgical Oncology</subject><subject>Survival Rate</subject><subject>Thyroid Neoplasms - mortality</subject><subject>Thyroid Neoplasms - pathology</subject><subject>Thyroid Neoplasms - surgery</subject><subject>Treatment Outcome</subject><subject>Young Adult</subject><issn>1068-9265</issn><issn>1534-4681</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2011</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><sourceid>BENPR</sourceid><recordid>eNp1kElLxEAQhRtRnHH5AV6k8eIp2nsnRwkuAyMKjicPIUvFyZDN7mQk_94OGRUEoaGX-t7rqofQGSVXlAl5bSkRXHiEEo9yxb1hD82pdC9C-XTfnYnyvYApOUNH1m4IoZoTeYhmzAkVU8Ecvb30Zlts4xIvqrYs0rgrmtriJschuELqCsuhatdxBjWkXVMNuKjxs8Og7iz-LLo1foSsL8vYDHi1HkxTZDiM6xTMCTrI49LC6W4_Rq93t6vwwVs-3S_Cm6WXck06L4cg8aXUPIDcrYS7eZIslzllTGRJLJTORMIY0zQXmQ9aKKVAUqaUpjIN-DG6nHxb03z0YLuoKmwKrqUamt5GvlRa-VyN5MUfctP0pnbNjRDVimniIDpBqWmsNZBHrSkqN15ESTTmHk25R2S8u9yjwWnOd8Z9UkH2o_gO2gFsAqwr1e9gfn_-3_ULuUaOIw</recordid><startdate>20110401</startdate><enddate>20110401</enddate><creator>Kandil, Emad</creator><creator>Gilson, Marta M.</creator><creator>Alabbas, Haytham H.</creator><creator>Tufaro, Anthony P.</creator><creator>Dackiw, Alan</creator><creator>Tufano, Ralph P.</creator><general>Springer-Verlag</general><general>Springer Nature B.V</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>3V.</scope><scope>7TO</scope><scope>7X7</scope><scope>7XB</scope><scope>88E</scope><scope>8AO</scope><scope>8FI</scope><scope>8FJ</scope><scope>8FK</scope><scope>ABUWG</scope><scope>AFKRA</scope><scope>BENPR</scope><scope>CCPQU</scope><scope>FYUFA</scope><scope>GHDGH</scope><scope>H94</scope><scope>K9.</scope><scope>M0S</scope><scope>M1P</scope><scope>PQEST</scope><scope>PQQKQ</scope><scope>PQUKI</scope><scope>PRINS</scope><scope>7X8</scope></search><sort><creationdate>20110401</creationdate><title>Survival Implications of Cervical Lymphadenectomy in Patients with Medullary Thyroid Cancer</title><author>Kandil, Emad ; Gilson, Marta M. ; Alabbas, Haytham H. ; Tufaro, Anthony P. ; Dackiw, Alan ; Tufano, Ralph P.</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c370t-fe9b855739ef9efb3010bdf5f1224dba467d4b22271f4d8e74666e51266715c93</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2011</creationdate><topic>Adolescent</topic><topic>Adult</topic><topic>Aged</topic><topic>Aged, 80 and over</topic><topic>Carcinoma, Medullary - mortality</topic><topic>Carcinoma, Medullary - pathology</topic><topic>Carcinoma, Medullary - surgery</topic><topic>Child</topic><topic>Endocrine Tumors</topic><topic>Female</topic><topic>Follow-Up Studies</topic><topic>Humans</topic><topic>Lymph Node Excision</topic><topic>Lymphatic Metastasis</topic><topic>Male</topic><topic>Medicine</topic><topic>Medicine & Public Health</topic><topic>Middle Aged</topic><topic>Neoplasm Staging</topic><topic>Oncology</topic><topic>Retrospective Studies</topic><topic>SEER Program</topic><topic>Surgery</topic><topic>Surgical Oncology</topic><topic>Survival Rate</topic><topic>Thyroid Neoplasms - mortality</topic><topic>Thyroid Neoplasms - pathology</topic><topic>Thyroid Neoplasms - surgery</topic><topic>Treatment Outcome</topic><topic>Young Adult</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Kandil, Emad</creatorcontrib><creatorcontrib>Gilson, Marta M.</creatorcontrib><creatorcontrib>Alabbas, Haytham H.</creatorcontrib><creatorcontrib>Tufaro, Anthony P.</creatorcontrib><creatorcontrib>Dackiw, Alan</creatorcontrib><creatorcontrib>Tufano, Ralph P.</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>ProQuest Central (Corporate)</collection><collection>Oncogenes and Growth Factors Abstracts</collection><collection>Health & Medical Collection</collection><collection>ProQuest Central (purchase pre-March 2016)</collection><collection>Medical Database (Alumni Edition)</collection><collection>ProQuest Pharma Collection</collection><collection>Hospital Premium Collection</collection><collection>Hospital Premium Collection (Alumni Edition)</collection><collection>ProQuest Central (Alumni) (purchase pre-March 2016)</collection><collection>ProQuest Central (Alumni Edition)</collection><collection>ProQuest Central UK/Ireland</collection><collection>ProQuest Central</collection><collection>ProQuest One Community College</collection><collection>Health Research Premium Collection</collection><collection>Health Research Premium Collection (Alumni)</collection><collection>AIDS and Cancer Research Abstracts</collection><collection>ProQuest Health & Medical Complete (Alumni)</collection><collection>Health & Medical Collection (Alumni Edition)</collection><collection>Medical Database</collection><collection>ProQuest One Academic Eastern Edition (DO NOT USE)</collection><collection>ProQuest One Academic</collection><collection>ProQuest One Academic UKI Edition</collection><collection>ProQuest Central China</collection><collection>MEDLINE - Academic</collection><jtitle>Annals of surgical oncology</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Kandil, Emad</au><au>Gilson, Marta M.</au><au>Alabbas, Haytham H.</au><au>Tufaro, Anthony P.</au><au>Dackiw, Alan</au><au>Tufano, Ralph P.</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Survival Implications of Cervical Lymphadenectomy in Patients with Medullary Thyroid Cancer</atitle><jtitle>Annals of surgical oncology</jtitle><stitle>Ann Surg Oncol</stitle><addtitle>Ann Surg Oncol</addtitle><date>2011-04-01</date><risdate>2011</risdate><volume>18</volume><issue>4</issue><spage>1028</spage><epage>1034</epage><pages>1028-1034</pages><issn>1068-9265</issn><eissn>1534-4681</eissn><abstract>Background
The relationship between extent of cervical lymphadenectomy along with the number of involved lymph nodes (LNs) removed and overall survival has not been well documented in patients with medullary thyroid carcinoma (MTC). This study investigates whether the overall number of LNs removed and the number of metastatic LNs are independent prognostic factors for overall survival.
Methods
Data from patients with MTC in the Surveillance, Epidemiology, and End Results (SEER) registry database were examined. After categorizing the study population based on the number of overall LNs examined and the number of metastatic LNs, survival estimates were compared. The total number of examined LNs and their histopathological status were analyzed for their prognostic value in estimating overall survival.
Results
593 patients were included in this study. Those with all negative LNs had the best overall survival; those with LNs examined and at least one positive LN had worst overall survival (
p
< 0.0001). The total number of examined LNs for both groups with negative and positive LNs was not associated with improved survival outcome (
p
= 0.41). In node-positive patients, each additional positive LN was significantly associated with an increase in overall mortality [hazard ratio (HR) = 1.05, 95% confidence interval (CI) = 1.02–1.08].
Conclusions
Cervical LN metastases conferred an independent risk for worse survival rate in MTC. Cervical lymphadenectomy is important for staging and regional disease control, however the extent of lymph node dissection, the overall number of lymph nodes removed along with removal of an increased number of involved lymph nodes do not confer a survival advantage. Future prospective studies are needed.</abstract><cop>New York</cop><pub>Springer-Verlag</pub><pmid>21046269</pmid><doi>10.1245/s10434-010-1363-y</doi><tpages>7</tpages></addata></record> |
| fulltext | fulltext |
| identifier | ISSN: 1068-9265 |
| ispartof | Annals of surgical oncology, 2011-04, Vol.18 (4), p.1028-1034 |
| issn | 1068-9265 1534-4681 |
| language | eng |
| recordid | cdi_proquest_miscellaneous_856768369 |
| source | MEDLINE; SpringerLink Journals |
| subjects | Adolescent Adult Aged Aged, 80 and over Carcinoma, Medullary - mortality Carcinoma, Medullary - pathology Carcinoma, Medullary - surgery Child Endocrine Tumors Female Follow-Up Studies Humans Lymph Node Excision Lymphatic Metastasis Male Medicine Medicine & Public Health Middle Aged Neoplasm Staging Oncology Retrospective Studies SEER Program Surgery Surgical Oncology Survival Rate Thyroid Neoplasms - mortality Thyroid Neoplasms - pathology Thyroid Neoplasms - surgery Treatment Outcome Young Adult |
| title | Survival Implications of Cervical Lymphadenectomy in Patients with Medullary Thyroid Cancer |
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