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Arch Iran Med. 27(8):466-467. doi: 10.34172/aim.31856

Correction

Correction to "Effects of Patient and Tumor Characteristics on Central Lymph Node Metastasis in Papillary Thyroid Cancer: a Guide for Selective Node Dissection"

Saygin Altiner 1 ORCID logo, Ramazan Kozan 2, * ORCID logo, Ahmet Cihangir Emral 3, Ferit Taneri 2, Ahmet Karamercan 2

Author information:
1Department of General Surgery, University of Health Sciences, Ankara Training and Research Hospital, Ankara, Turkey
2Department of General Surgery, Faculty of Medicine, Gazi University, Ankara, Turkey
3Department of General Surgery, Sincan State Hospital, Ankara, Turkey

*Corresponding Author: Ramazan Kozan, Emails: dr.kozan@hotmail.com & ramazankozan@gazi.edu.tr

Copyright and License Information

© 2024 The Author(s).
This is an open-access article distributed under the terms of the Creative Commons Attribution License (https://creativecommons.org/licenses/by/4.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

Cite this article as: Altiner S, Kozan R, Emral AC, Taneri F, Karamercan A. Correction to "effects of patient and tumor characteristics on central lymph node metastasis in papillary thyroid cancer: a guide for selective node dissection". Arch Iran Med. 2024;27(8):466-467. doi: 10.34172/aim.31856


Dear Editor,

We have carefully reviewed the letter regarding our article titled “Effects of Patient and Tumor Characteristics on Central Lymph Node Metastasis in Papillary Thyroid Cancer: A Guide for Selective Node Dissection”.1 We sincerely appreciate the valuable comments and attention given by Shahraki HR.2

We have re-examined the data set and statistical analyses retrospectively, and we also thoroughly reviewed all the analyses. We acknowledge that there were errors in transferring the results to the tables during the stage of presenting the outcomes associated with the conduct of univariate and multivariate analyses by different individuals. Additionally, we recognize that providing more detailed information in the tables would strengthen the comprehensibility of our study. Consequently, in the multiple logistic regression, we have reported odds ratios for individual categories by accepting one category as the baseline for quantitative variables with more than two categories.

However, it is essential to emphasize that these corrections have not led to any changes in the findings and conclusions of our study.

Below are the revised and detailed Table 2 and Table 3, reflecting the numerical changes in the results of univariate and multivariable analyses. The corrected paragraph in the “Results” section reads as follows:


Table 2. Factors Affecting Central Lymph Node Metastasis
Factors CLNM (-) CLNM (+) P Value OR 95% CI
n % n %
Age group (n = 255)
 < 45 years 71 40.1% 106 59.9% 0.016 1.00 0.30-0.89
 ≥ 45 years 44 56.4% 34 43.6% 0.52
χ2 = 5.808
Sex (n = 255)
Men 20 32.8% 41 67.2% 0.027 1.97 1.07-3.60
Women 95 49.0% 99 51.0% 1.00
χ2 = 4.908
Intra-thyroidal localization (n = 236)
Superior 45 69.2% 20 30.8%  < 0.001 0.13 0.06-0.28
Middle 22 48.9% 23 51.1% 0.29 0.13-0.69
Inferior 13 22.0% 46 78.0% 1.00
Isthmus/junction 15 37.5% 25 62.5% 0.47 0.19-1.14
Multilobar 9 33.3% 18 66.7% 0.56 0.21-1.55
χ2 = 30.705
Tumor subtype (n = 255)
Classic 80 43.2% 105 56.8% 0.010 1.00
Follicular variant 30 61.2% 19 38.8% 0.48 0.25-0.92
Others 5 23.8% 16 76.2% 2.43 0.86-6.94
χ2 = 9.248
Lymphovascular invasion (n = 255)
No 99 94.3% 6 5.7%  < 0.001 1.00 52.20-365.83
Yes 16 10.7% 134 89.3% 138.19
χ2 = 174,424
Extracapsular invasion (n = 255)
No 114 46.9% 129 53.1% 0.020 1.00 1.24-76.47
Yes 1 8.3% 11 91.7% 9.72
χ2 = 6.874

CLNM, central lymph node metastasis; OR, odds ratio; CI, confidence interval.


Table 3. Independent Predictive Factors of Central Lymph Node Metastasis in Multivariate Analysis
Factors OR 95% CI P Value
Age group 0.09-0.81 0.020
 < 45 years 1.00
 ≥ 45 years 0.27
Sex 1.16-15.63 0.029
Men 4.26
Women 1.00
Intra-thyroidal localization
Superior 0.39 0.09-1.66 0.204
Middle 0.81 0.17-3.85 0.790
Inferior 1.00
Isthmus/junction 0.63 0.12-3.45 0.598
Multilober 1.17 0.20-6.74 0.861
Tumor subtype
Classic 1.00
Follicular variant 0.17 0.05-0.57 0.004
Others 0.58 0.06-5.33 0.634
Lymphovascular invasion
No 1.00 65.55-1087.18  < 0.001
Yes 266.96
Extracapsular invasion
No 1.00 1.51-737.15 0.026
Yes 33.37

OR, odds ratio; CI, confidence interval

‘In univariate analysis, the risk of CLNM was shown to be higher in those under 45 years of age than those aged 45 years and above [odds ratio (OR) = 0.52, 95% CI 0.30−0.89, P = 0.016]. Additionally, male gender was associated an elevated risk of CLNM (OR = 1.97, 95% CI 1.07−3.60, P = 0.027). Other risk factors for CLNM were lymphovascular invasion (OR = 138.19, 95% CI 52.20−365.83, P < 0.001) and extracapsular invasion (OR = 9.72, 95% CI 1.24−76.47, P = 0.020). The relationship between histopathological subtypes of the tumor and CLNM was examined, and it was found that the follicular variant subtype had a lower probability of metastasis than the other subtypes (95% CI 0.25−0.92, P = 0.010). When the localization of the tumor in the thyroid lobe was evaluated, it was shown that tumors situated in the superior lobe had a lower probability of CLNM than tumors located in the other lobes (95% CI 0.06−0.28, P < 0.001) (Table 2). There was no relationship between CLNM and whether the tumor was unifocal or multifocal (OR = 1.67, 95% CI 0.99−2.80, P = 0.054). Multivariable analysis revealed that age at diagnosis (OR = 0.27, 95% CI 0.09−0.81, P = 0.020), gender (OR = 4.26, 95% CI 1.16−15.63, P = 0.029), tumor subtype for follicular variant (OR = 0.17, 95% CI 0.05−0.57, P = 0.004), lymphovascular invasion (OR = 266.96, 95% CI 65.55−1087.18, P < 0.001) and extracapsular invasion (OR = 33.37, 95% CI 1.51–737.15, P = 0.026) were statistically significant independent predictive factors. However, intra-thyroidal localization of the tumor was not significant for CLNM (Table 3).’

In conclusion, we believe that the valuable critiques and suggestions provided have enhanced the statistical transparency and accuracy of our study. We recognize the significance of reader engagement in research publications and how it contributes to the advancement of published studies.


Competing Interests

The authors have no conflict of interest to declare.

Ethical Approval

Not applicable.


References

  1. Altiner S, Kozan R, Emral AC, Taneri F, Karamercan A. Effects of patient and tumor characteristics on central lymph node metastasis in papillary thyroid cancer: a guide for selective node dissection. Arch Iran Med 2022; 25(11):730-6. doi: 10.34172/aim.2022.115 [Crossref] [ Google Scholar]
  2. Shahraki HR. Comments on “Effects of patient and tumor characteristics on central lymph node metastasis in papillary thyroid cancer: a guide for selective node dissection”. Arch Iran Med 2024; 27(8):59. doi: 10.34172/aim.27317 [Crossref] [ Google Scholar]
Submitted: 07 May 2024
Accepted: 15 Jun 2024
First published online: 01 Aug 2024
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