Assessing the role of central lymph node ratio in predicting recurrence in N1a low-to-intermediate risk papillary thyroid carcinoma
IntroductionLymph node metastasis in patients with papillary thyroid carcinoma (PTC) is associated with postoperative recurrence. Recently, most studies have focused on the evaluation of recurrence in patients with late-stage PTC, with limited data on those with early-stage PTC. We aimed to assess t...
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Frontiers Media S.A.
2023-09-01
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| Series: | Frontiers in Endocrinology |
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| Online Access: | https://www.frontiersin.org/articles/10.3389/fendo.2023.1158826/full |
| _version_ | 1827818073926664192 |
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| author | Teng Ma Teng Ma Jian Cui Peng Shi Mei Liang Wenxiao Song Xueyan Zhang Lulu Wang Yafei Shi |
| author_facet | Teng Ma Teng Ma Jian Cui Peng Shi Mei Liang Wenxiao Song Xueyan Zhang Lulu Wang Yafei Shi |
| author_sort | Teng Ma |
| collection | DOAJ |
| description | IntroductionLymph node metastasis in patients with papillary thyroid carcinoma (PTC) is associated with postoperative recurrence. Recently, most studies have focused on the evaluation of recurrence in patients with late-stage PTC, with limited data on those with early-stage PTC. We aimed to assess the relationship between lymph node ratio (LNR) and recurrence in low-to-intermediate-risk patients and validate its diagnostic efficiency in both structural (STR) and biochemical recurrence (BIR).MethodsClinical data of patients with PTC diagnosed at the Affiliated Hospital of Jining Medical University were retrospectively collected. The optimal LNR cut-off values for disease-free survival (DFS) were determined using X-tile software. Predictors were validated using univariate and multivariate Cox regression analyses.ResultsLNR had a higher diagnostic effectiveness than metastatic lymph nodes in patients with low-to-intermediate recurrence risk N1a PTC. The optimal LNR cutoff values for STR and BIR were 0.75 and 0.80, respectively. Multivariate Cox regression analysis showed that LNR≥0.75 and LNR≥0.80 were independent factors for STR and BIR, respectively. The 5-year DFS was 90.5% in the high LNR (≥0.75) and 96.8% in low LNR (<0.75) groups for STR. Regarding BIR, the 5-year DFS was 75.7% in the high LNR (≥0.80) and 86.9% in low LNR (<0.80) groups. The high and low LNR survival curves exhibited significant differences on the log-rank test.ConclusionLNR was associated with recurrence in patients with low-to-intermediate recurrence risk N1a PTC. We recommend those with LNR≥0.75 require a comprehensive evaluation of lateral neck lymphadenopathy and consideration for lateral neck dissection and RAI treatment. |
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| language | English |
| last_indexed | 2024-03-12T00:42:49Z |
| publishDate | 2023-09-01 |
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| series | Frontiers in Endocrinology |
| spelling | doaj.art-0e419d44f2f64c778f13a0347a4325b42023-09-15T01:30:51ZengFrontiers Media S.A.Frontiers in Endocrinology1664-23922023-09-011410.3389/fendo.2023.11588261158826Assessing the role of central lymph node ratio in predicting recurrence in N1a low-to-intermediate risk papillary thyroid carcinomaTeng Ma0Teng Ma1Jian Cui2Peng Shi3Mei Liang4Wenxiao Song5Xueyan Zhang6Lulu Wang7Yafei Shi8Department of Thyroid Surgery, Affiliated Hospital of Jining Medical University, Jining, Shandong, ChinaBreast Disease Center, Affiliated Hospital of Qingdao University, Qingdao, Shandong, ChinaBreast Disease Center, Affiliated Hospital of Qingdao University, Qingdao, Shandong, ChinaDepartment of Thyroid Surgery, Affiliated Hospital of Jining Medical University, Jining, Shandong, ChinaDepartment of Thyroid Surgery, Affiliated Hospital of Jining Medical University, Jining, Shandong, ChinaDepartment of Thyroid Surgery, Affiliated Hospital of Jining Medical University, Jining, Shandong, ChinaQingdao Medical College, Qingdao University, Qingdao, Shandong, ChinaDepartment of Cardiovascular Surgery, Affiliated Hospital of Qingdao University, Qingdao, Shandong, ChinaDepartment of Thyroid Surgery, Affiliated Hospital of Jining Medical University, Jining, Shandong, ChinaIntroductionLymph node metastasis in patients with papillary thyroid carcinoma (PTC) is associated with postoperative recurrence. Recently, most studies have focused on the evaluation of recurrence in patients with late-stage PTC, with limited data on those with early-stage PTC. We aimed to assess the relationship between lymph node ratio (LNR) and recurrence in low-to-intermediate-risk patients and validate its diagnostic efficiency in both structural (STR) and biochemical recurrence (BIR).MethodsClinical data of patients with PTC diagnosed at the Affiliated Hospital of Jining Medical University were retrospectively collected. The optimal LNR cut-off values for disease-free survival (DFS) were determined using X-tile software. Predictors were validated using univariate and multivariate Cox regression analyses.ResultsLNR had a higher diagnostic effectiveness than metastatic lymph nodes in patients with low-to-intermediate recurrence risk N1a PTC. The optimal LNR cutoff values for STR and BIR were 0.75 and 0.80, respectively. Multivariate Cox regression analysis showed that LNR≥0.75 and LNR≥0.80 were independent factors for STR and BIR, respectively. The 5-year DFS was 90.5% in the high LNR (≥0.75) and 96.8% in low LNR (<0.75) groups for STR. Regarding BIR, the 5-year DFS was 75.7% in the high LNR (≥0.80) and 86.9% in low LNR (<0.80) groups. The high and low LNR survival curves exhibited significant differences on the log-rank test.ConclusionLNR was associated with recurrence in patients with low-to-intermediate recurrence risk N1a PTC. We recommend those with LNR≥0.75 require a comprehensive evaluation of lateral neck lymphadenopathy and consideration for lateral neck dissection and RAI treatment.https://www.frontiersin.org/articles/10.3389/fendo.2023.1158826/fullpapillary thyroid carcinomalymph node ratiostructural recurrencebiochemical recurrencetotal thyroidectomy |
| spellingShingle | Teng Ma Teng Ma Jian Cui Peng Shi Mei Liang Wenxiao Song Xueyan Zhang Lulu Wang Yafei Shi Assessing the role of central lymph node ratio in predicting recurrence in N1a low-to-intermediate risk papillary thyroid carcinoma Frontiers in Endocrinology papillary thyroid carcinoma lymph node ratio structural recurrence biochemical recurrence total thyroidectomy |
| title | Assessing the role of central lymph node ratio in predicting recurrence in N1a low-to-intermediate risk papillary thyroid carcinoma |
| title_full | Assessing the role of central lymph node ratio in predicting recurrence in N1a low-to-intermediate risk papillary thyroid carcinoma |
| title_fullStr | Assessing the role of central lymph node ratio in predicting recurrence in N1a low-to-intermediate risk papillary thyroid carcinoma |
| title_full_unstemmed | Assessing the role of central lymph node ratio in predicting recurrence in N1a low-to-intermediate risk papillary thyroid carcinoma |
| title_short | Assessing the role of central lymph node ratio in predicting recurrence in N1a low-to-intermediate risk papillary thyroid carcinoma |
| title_sort | assessing the role of central lymph node ratio in predicting recurrence in n1a low to intermediate risk papillary thyroid carcinoma |
| topic | papillary thyroid carcinoma lymph node ratio structural recurrence biochemical recurrence total thyroidectomy |
| url | https://www.frontiersin.org/articles/10.3389/fendo.2023.1158826/full |
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