BACKGROUND: Lymph node ratio (LNR) is an important prognosis factor in many solid cancers, but there have been few reports of LNR in papillary thyroid carcinoma (PTC). This study investigated LNR of the central compartment to determine whether LNR has clinical significance as a prognostic predictor for recurrence after prophylactic central neck dissection (pCND) in patients with PTC. METHODS: The study includes 295 consecutive patients who underwent total thyroidectomy with bilateral pCND, which was pathologically diagnosed as N1a PTC. LNR was calculated as the ratio of positive LN to total LN removed. RESULTS: LNR of 0.65 was significantly meaningful for recurrence when three or more LNs were collected (P < 0.001). The 10-year estimated recurrence-free survival rates were 98.6 % for patients with LNR ≤0.65 and 75.4 % for patients with LNR >0.65 (P < 0.001). Univariate analysis revealed that increasing tumor size and LNR >0.65 were significantly associated with recurrence (P < 0.05 each). No significant association with recurrence was found for age ≥45 years, male gender, microscopic extrathyroidal extension, coexistent chronic lymphocytic thyroiditis, T classification, multicentricity, number of positive LN, and extranodal extension (P > 0.05 each). The only independent variable for recurrence identified by multivariate analysis was LNR >0.65 (P < 0.001). CONCLUSIONS: LNR may be a useful predictor to stratify the likelihood of recurrence after pCND in patients with pathologic N1a PTC.
BACKGROUND: Lymph node ratio (LNR) is an important prognosis factor in many solid cancers, but there have been few reports of LNR in papillary thyroid carcinoma (PTC). This study investigated LNR of the central compartment to determine whether LNR has clinical significance as a prognostic predictor for recurrence after prophylactic central neck dissection (pCND) in patients with PTC. METHODS: The study includes 295 consecutive patients who underwent total thyroidectomy with bilateral pCND, which was pathologically diagnosed as N1a PTC. LNR was calculated as the ratio of positive LN to total LN removed. RESULTS: LNR of 0.65 was significantly meaningful for recurrence when three or more LNs were collected (P < 0.001). The 10-year estimated recurrence-free survival rates were 98.6 % for patients with LNR ≤0.65 and 75.4 % for patients with LNR >0.65 (P < 0.001). Univariate analysis revealed that increasing tumor size and LNR >0.65 were significantly associated with recurrence (P < 0.05 each). No significant association with recurrence was found for age ≥45 years, male gender, microscopic extrathyroidal extension, coexistent chronic lymphocytic thyroiditis, T classification, multicentricity, number of positive LN, and extranodal extension (P > 0.05 each). The only independent variable for recurrence identified by multivariate analysis was LNR >0.65 (P < 0.001). CONCLUSIONS: LNR may be a useful predictor to stratify the likelihood of recurrence after pCND in patients with pathologic N1a PTC.
Authors: Hyeong Won Yu; In Eui Bae; Jin Wook Yi; Joon-Hyop Lee; Su-Jin Kim; Young Jun Chai; June Young Choi; Kyu Eun Lee Journal: Surg Today Date: 2019-01-02 Impact factor: 2.549
Authors: Bryan R Haugen; Erik K Alexander; Keith C Bible; Gerard M Doherty; Susan J Mandel; Yuri E Nikiforov; Furio Pacini; Gregory W Randolph; Anna M Sawka; Martin Schlumberger; Kathryn G Schuff; Steven I Sherman; Julie Ann Sosa; David L Steward; R Michael Tuttle; Leonard Wartofsky Journal: Thyroid Date: 2016-01 Impact factor: 6.568
Authors: Moran Amit; Samantha Tam; Mongkol Boonsripitayanon; Maria E Cabanillas; Naifa L Busaidy; Elizabeth Gardner Grubbs; Stephen Y Lai; Neil D Gross; Erich M Sturgis; Mark E Zafereo Journal: JAMA Otolaryngol Head Neck Surg Date: 2018-02-01 Impact factor: 6.223