Prevalence, Risk Factors And Location Of Skip Metastasis In Papillary Thyroid Carcinoma: A Systematic Review And Meta-Analysis

Skip metastasis is a special type in cervical lymph node metastasis (LNM) of patients diagnosed with papillary thyroid carcinoma (PTC) which induced poor prognosis. There are few studies about skip metastasis and conclusions remained uncertain. Therefore, this study aims to explore the frequency and...

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Bibliographic Details
Published in:Cancer management and research 2019-01, Vol.11, p.8721-8730
Main Authors: Qiu, Yuxuan, Fei, Yuan, Liu, Jingyan, Liu, Chang, He, Xin, Zhu, Ning, Zhao, Wan-Jun, Zhu, Jing-Qiang
Format: Article
Language:English
Subjects:
Biopsy
Cancer metastasis
Carcinoma
Dissection
Health aspects
Hospitals
lateral neck dissection
Lymphatic system
Medical research
Meta-analysis
Metastasis
Neck
papillary thyroid carcinoma
Prognosis
Review
Risk factors
skip metastasis
Studies
Surgery
Systematic review
Thyroid cancer
Thyroid diseases
Thyroiditis
Tumors
Ultrasonic imaging
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Summary:Skip metastasis is a special type in cervical lymph node metastasis (LNM) of patients diagnosed with papillary thyroid carcinoma (PTC) which induced poor prognosis. There are few studies about skip metastasis and conclusions remained uncertain. Therefore, this study aims to explore the frequency and to investigate risk factors of skip metastasis in PTC. Through searching the keyword by PubMed and Embase databases which articles published up to 1 August 2018 about skip metastasis in papillary thyroid carcinoma, we extract data in order to assure whether those materials meet the criteria. The prevalence of skip metastasis is 12.02% in light of our meta-analysis of 18 studies with 2165 patients. The upper pole location (RR = 3.35, 95% CI =1.65-6.79, P = 0.0008) and tumors size ≤1 cm (RR = 2.65, 95% CI =1.50-4.70, P = 0.0008) are significantly associated with skip metastasis, whereas lymphovascular invasion (RR = 0.33, 95% CI =0.15-0.75, P = 0.0083) exists lower rate of skip metastasis. Multifocality, gender, age, bilaterality, thyroiditis and Extrathyroidal extension (ETE) are insignificantly associated with skip metastasis. Level II and level III are the most frequently affected areas. The lateral compartment should be carefully examined especially for those PTC patients who present primary tumors in the upper lobe with a primary tumor size ≤10 mm which could be detected with skip metastasis.
ISSN:1179-1322
1179-1322
DOI:10.2147/CMAR.S200628