Clinicopathological predictors of right para esophageal lymph node metastasis in papillary thyroid carcinoma: A systematic review and meta-analysis
Why this work is in the frame
A frame that forgets how it found something cannot be audited. These are the routes that admitted this work.
Bibliographic record
Abstract
BACKGROUND Dissection of the right paraesophageal lymph node (RPELN) in managing papillary thyroid carcinoma remains a contentious issue. This meta-analysis assesses previously established and novel risk factors associated with RPELN metastasis. AIM To evaluate previously established and novel risk factors associated with RPELN metastasis in patients with papillary thyroid carcinoma papillary thyroid carcinoma through a comprehensive meta-analysis. METHODS We searched MEDLINE (via PubMed), ScienceDirect, Scopus and EMBASE up to December 2024. Studies were assessed using the Newcastle-Ottawa Scale. Statistical analysis was conducted with RevMan version 5.4, using the Q -test and I 2-test for heterogeneity. Sensitivity was evaluated with the leave-one-out method, and publication bias with the Egger regression test and funnel plot. RESULTS Of 2444 articles retrieved, 26 were included in our meta-analysis with 16427 patients. The RPELN metastasis rate was 12.98% [95% confidence interval (CI): 12.46%-13.50%]. The pooled results suggested that age < 55 years [odds ratio (OR) = 1.71, 95%CI: 1.35-2.16, P < 0.00001], sex (OR = 0.60, 95%CI: 0.54-0.67, P < 0.00001), tumor size 1 cm (OR = 3.37, 95%CI: 2.69-4.21, P < 0.00001), multifocality (OR = 1.81, 95%CI: 1.49-2.20, P < 0.00001), capsular invasion (OR = 2.94, 95%CI: 2.05-4.20, P < 0.00001), vascular invasion (OR = 2.16, 95%CI: 1.56-2.99, P < 0.00001), extra-thyroid extension (OR = 3.30, 95%CI: 1.82-5.98, P < 0.0001), central lymph node metastasis (OR = 7.77, 95%CI: 4.73-12.76, P < 0.00001), lateral lymph node metastasis (OR = 6.94, 95%CI: 6.11-7.89, P < 0.00001), Hashimoto thyroiditis (OR = 0.79, 95%CI: 0.69-0.92, P = 0.002), micro-calcifications (OR = 2.29, 95%CI: 1.20-4.37, P = 0.01), and echogenicity (OR = 0.62, 95%CI: 0.40-0.98, P = 0.04) should be considered with RPELN metastasis. CONCLUSION The male < 55, tumor size > 1 cm, multifocality, capsular and vascular invasion, extrathyroidal extension, lymph node metastasis, and Hashimoto thyroiditis were significantly associated with RPELN metastasis and should be carefully assessed during dissection.
Fetched live from OpenAlex and de-inverted. Abstracts are not stored in this database: the inverted indexes are 8.6 GB of the frame’s 9.3 GB of text, and the host has 13 GB free.
Full frame distilled prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. Learned from the 10,348 direct Codex labels and 10,348 direct Gemma labels. Candidate is the union of thresholded teacher heads; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels or direct frontier model labels.
Codex and Gemma teacher scores by category
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.010 | 0.004 |
| Meta-epidemiology (narrow) | 0.001 | 0.000 |
| Meta-epidemiology (broad) | 0.045 | 0.013 |
| Bibliometrics | 0.001 | 0.002 |
| Science and technology studies | 0.000 | 0.000 |
| Scholarly communication | 0.000 | 0.000 |
| Open science | 0.001 | 0.000 |
| Research integrity | 0.001 | 0.002 |
| Insufficient payload (model declined to judge) | 0.000 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from it