Song E, et al. - The present study was to observe whether extensive cervical lymph node (LN) dissection is responsible for favorable clinical outcomes in papillary thyroid carcinoma (PTC) patients with Hashimoto's thyroiditis (HT) and whether coexistence of HT itself has an independent protective effect regardless of LN status. It was concluded that coexistence of HT itself is an independent factor associated with favorable outcome in PTC patients, regardless of extent of LN dissection.

Methods

• This was a retrospective cohort study including a total of 1,369 patients with PTC who underwent total thyroidectomy with central compartment neck dissection.
• Thereafter, metastatic LN ratio, characterized as number of metastatic LNs divided by number of removed LNs, was applied to assess the extent of LN dissection as well as the status of LN metastasis.
• They compared disease-free survival and dynamic risk stratification for clinical outcomes.

Results

• They observed that presence of HT did not lower the risk of cervical LN metastasis (61.6% in patients with HT vs. 65.1% in patients without HT, p=0.292).
• According to the data, patients with HT had significantly larger numbers of removed LNs than patients without HT (11 vs. 8, respectively, p<0.001).
• Evidence showed that metastatic LN ratio was smaller in patients with HT (p=0.002) which was independently associated with structural persistent/recurrent disease (hazard ratio [HR] 2.33, 95% confidence interval [CI] 1.30-4.16, p=0.004).
• It was noted that HT itself was negatively associated with structural persistent/recurrent disease after adjustment for other clinicopathological factors (HR 0.39, 95% CI 0.18–0.87, p=0.020).