Evidence map›Paper›PMID 32055968›Full record

ArticleWorld journal of surgery2020

Positive Lymph Node Counts in American Thyroid Association Low-Risk Papillary Thyroid Carcinoma Patients.

Martha J Griffin, Fred M Baik, Margaret Brandwein-Weber, Muhammad Qazi, Lauren E Yue, Marcela Osorio, Mark L Urken

Abstract read
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In one paragraph

Article in World journal of surgery, 2020. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 2 papers, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
2citing papers in PubMed, 1 pooled it
0.3field-weighted citation impact, top 42% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

2 citing papers in PubMed, 1 synthesis or guideline pooled it, 4 citations in OpenAlex.

  1. Guideline
  2. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

7 authors at 5 institutions in 1 country.

Martha J GriffinTHANC (Thyroid, Head and Neck Cancer) Foundation, 10 Union Square East, New York, NY, 10003, USA. mgriffin@thancfoundation.org.ORCID 0000-0001-5666-3602
Fred M BaikDepartment of Otolaryngology - Head and Neck Surgery, Stanford University Medical Center, Stanford, CA, USA.
Margaret Brandwein-WeberDepartment of Pathology, Mount Sinai West, Mount Sinai Health System, New York, NY, USA.
Muhammad QaziDepartment of Pathology, University of Wisconsin School of Medicine, Madison, WI, USA.
Lauren E YueTHANC (Thyroid, Head and Neck Cancer) Foundation, 10 Union Square East, New York, NY, 10003, USA.
Marcela OsorioTHANC (Thyroid, Head and Neck Cancer) Foundation, 10 Union Square East, New York, NY, 10003, USA.
Mark L UrkenTHANC (Thyroid, Head and Neck Cancer) Foundation, 10 Union Square East, New York, NY, 10003, USA.
Thyroid Head and Neck Cancer Foundation · USMount Sinai Beth Israel · USMount Sinai Health System · USStanford Medicine · USUniversity of Wisconsin–Madison · US

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundCurrent American Thyroid Association (ATA) guidelines state that patients with intermediate-risk papillary thyroid cancer (PTC) may benefit from remnant ablation. One criterion for intermediate-risk classification is >5 positive lymph nodes (LNs). We investigate whether performing step-sectioning of LNs increases the metastatic detection rate, thereby influencing ATA risk of recurrence (ROR) classification.

methodsA retrospective review was conducted of cases in which ≥ 5 LNs were removed during thyroidectomy and ≤5 LNs were found positive for PTC. Step-sectioning was performed on the original tissue blocks. All slides were re-reviewed by a senior pathologist.

resultsTwenty patients met study criteria. Step-sectioning significantly increased LN yield compared to standard sectioning. In total, we found 12 new positive lymph nodes; seven (58%) were in totally new lymph nodes, while five (42%) were in lymph nodes previously read as negative. All newly discovered metastases were classified as micrometastases (≤2 mm). Of the 15 patients originally classified as low-risk, the step-sectioning protocol impacted two patients (13%), increasing ROR stratification.

conclusionIntensive step-sectioning reveals additional micrometastases. More detailed analysis did not identify clinically significant nodal disease likely to impact the clinical course of patients in this study. Our study supports current standards of pathology specimen handling related to LN assessment and the impact on ATA ROR classification. Nonetheless, it is important for clinicians to understand their institution's sectioning protocol utilized to report positive and total LN counts, which could impact ATA risk stratification and denote the comprehensive nature of the LN dissection that was performed.

Indexed as

AdolescentAdultAgedChildFemaleHumansLymphatic MetastasisLymph NodesMaleMiddle AgedNeoplasm Recurrence, LocalRetrospective StudiesThyroid Cancer, PapillaryThyroid NeoplasmsYoung Adult

Identifiers

PMID32055968
OpenAlexW3005800404

What OpenQuestion holds

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Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.