Citations 1
SUN-292 Examining Predictive Elements Influencing Metastasis to Right Para Esophageal Lymph Nodes in Papillary Thyroid Carcinoma: A Systematic Review and Meta-Analysis
Haider, Rabbia , Khawar, Muneeb , Abid, Muhammad Hanan, Khawar, Mirza Muhammad Hadeed , Shaukat, Muneeba, Cheema, M S, Komel, Aqsa, Khan, Muhammad Huzaifa Ahmed, Noureen, Rimsha, Batool, Arshia , Qadeer, Abdul, Ullah, Aman, Abid, Muhammad Hanan, Shaukat, Muneeba, Cheema, Muhammad Bilal Asad, Mubashir, Mohammad Maheer, Kirchoff, Robert W.
Journal of the Endocrine Society | October 23, 2025 | Volume: 9 | Issue: Supplement_1 | Pages: No page available
Abstract Disclosure: A. Ullah: None. R. Haider: None. M. Khawar: None. M. Abid: None. M. Hadeed Khawar: None. M. Shaukat: None. M. Asad Cheema: None. A. Komel: None. M. Ahmed Khan: None. R. Noureen: None. A. Batool: None. M. Mubashir: None. A. Qadeer: None. R. W. Kirchoff: None. Background: The role of dissecting the right paraesophageal lymph node (RPELN) in managing papillary thyroid carcinoma (PTC) remains a subject of debate. This meta-analysis examines both established and novel risk factors associated with RPELN metastasis. Methods: Relevant studies published up to December 2024 were retrieved using PubMed, Embase, Ovid, and Scopus search engines. Data were extracted and evaluated using the Newcastle-Ottawa scale. Statistical analysis was performed using Review Manager 5.4, with heterogeneity assessed through the Q-test and I²-test. Sensitivity analysis was conducted using the leave-one-out method, and the Egger regression test was used to generate a funnel plot for publication bias assessment. Results: Out of 2,444 articles screened, 26 studies involving 16,427 patients were included in the meta-analysis. The overall RPELN metastasis rate was 12.98% (2,133/16,427). The pooled analysis revealed significant associations between RPELN metastasis and the following factors: age under 55 years (P < 0.00001), male gender (P < 0.00001), tumor size >1 cm (P < 0.00001), multifocality (P < 0.00001), capsular invasion (P < 0.00001), vascular invasion (P < 0.00001), extra-thyroidal extension (P < 0.0001), central lymph node metastasis (P < 0.00001), lateral lymph node metastasis (P < 0.00001), Hashimoto’s thyroiditis (P = 0.002), micro-calcifications (P = 0.01), and altered echogenicity (P = 0.03). Conversely, no significant associations were observed for tumor location in the right lobe (P = 0.07), superior pole (P = 0.08), middle pole (P = 1.00), inferior pole (P = 0.28), or tumor margins (P = 0.93) (all P > 0.05). Conclusion: Factors such as age <55, male sex, tumor size >1 cm, multifocality, capsular invasion, vascular invasion, extra-thyroidal extension, central lymph node metastasis, lateral lymph node metastasis, and Hashimoto’s thyroiditis are significantly associated with RPELN metastasis. These should be carefully considered during RPELN dissection in PTC management. Presentation: Sunday, July 13, 2025