Lymph node metastases >5 and metastatic lymph node ratio >0.30 of differentiated thyroid cancer predict response to radioactive iodine
Abstract Purpose The study was designed to elucidate the predictive value of the number of lymph node metastases (LNMs) and lymph node ratio (LNR) for response to therapy restratification system (RTRS). Methods From December 2015 to December 2019, 1228 patients who accepted radioactive iodine (RAI)...
| Main Authors: | , , , , , , |
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| Format: | Article |
| Language: | English |
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Wiley
2021-11-01
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| Series: | Cancer Medicine |
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| Online Access: | https://doi.org/10.1002/cam4.4288 |
| _version_ | 1819118292950843392 |
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| author | Canhua Yun Juan Xiao Jingjia Cao Chunchun Shao Lihua Wang Wei Zhang Hongying Jia |
| author_facet | Canhua Yun Juan Xiao Jingjia Cao Chunchun Shao Lihua Wang Wei Zhang Hongying Jia |
| author_sort | Canhua Yun |
| collection | DOAJ |
| description | Abstract Purpose The study was designed to elucidate the predictive value of the number of lymph node metastases (LNMs) and lymph node ratio (LNR) for response to therapy restratification system (RTRS). Methods From December 2015 to December 2019, 1228 patients who accepted radioactive iodine (RAI) were collected in the study. After 6–8 months, response to RAI was evaluated as complete response (excellent response) and incomplete response (indeterminate, biochemical, and structural incomplete response). The study developed classification tree to determine the optimum LNMs and LNR that predicted response to RAI. Multivariate logistic regression analyses were further analyzed to find independent factors of response to RAI. Result The mean age of patients was 44 ± 12 and 71.09% (873/1228) were females. The best cutoff value of LNMs to affect RAI treatment response determined by classification tree was 5. Further in 388 patients with LNMs >5, the best cutoff value of LNR to affect RAI treatment response determined by classification tree was 0.30. With multivariate analysis, the study found that LNMs (>5), gender, lymph node dissection, and American Thyroid Association (ATA) risk classification were independent predictors of response to RAI for all 1228 patients; and LNR (>0.30), gender, and ATA risk classification for 388 patients with LNMs >5. The sensitivity analysis indicated that whether patients with LNM or not were included, the multivariate logistic regression model was kept stable. On subgroup analysis, no significant interactions were observed between the effect of LNMs/LNR and gender, N stage, ATA risk classification, lymph node dissection, or T stage. Conclusions With classification tree, the study found that LNMs and LNR could predict initial response to RAI, and their optimal cutoff values were 5 and 0.30, separately. |
| first_indexed | 2024-12-22T05:46:34Z |
| format | Article |
| id | doaj.art-eca9931432c240aa9289dbef34d01e93 |
| institution | Directory Open Access Journal |
| issn | 2045-7634 |
| language | English |
| last_indexed | 2024-12-22T05:46:34Z |
| publishDate | 2021-11-01 |
| publisher | Wiley |
| record_format | Article |
| series | Cancer Medicine |
| spelling | doaj.art-eca9931432c240aa9289dbef34d01e932022-12-21T18:37:01ZengWileyCancer Medicine2045-76342021-11-0110217610761910.1002/cam4.4288Lymph node metastases >5 and metastatic lymph node ratio >0.30 of differentiated thyroid cancer predict response to radioactive iodineCanhua Yun0Juan Xiao1Jingjia Cao2Chunchun Shao3Lihua Wang4Wei Zhang5Hongying Jia6Department of Nuclear Medicine The Second HospitalCheeloo College of MedicineShandong University Jinan ChinaCenter of Evidence‐Based Medicine The Second HospitalCheeloo College of MedicineInstitute of Medical SciencesShandong University Jinan ChinaDepartment of Nuclear Medicine The Second HospitalCheeloo College of MedicineShandong University Jinan ChinaCenter of Evidence‐Based Medicine The Second HospitalCheeloo College of MedicineInstitute of Medical SciencesShandong University Jinan ChinaSchool of Public Health Cheeloo College of MedicineShandong University Jinan ChinaDepartment of Nuclear Medicine The Second HospitalCheeloo College of MedicineShandong University Jinan ChinaCenter of Evidence‐Based Medicine The Second HospitalCheeloo College of MedicineInstitute of Medical SciencesShandong University Jinan ChinaAbstract Purpose The study was designed to elucidate the predictive value of the number of lymph node metastases (LNMs) and lymph node ratio (LNR) for response to therapy restratification system (RTRS). Methods From December 2015 to December 2019, 1228 patients who accepted radioactive iodine (RAI) were collected in the study. After 6–8 months, response to RAI was evaluated as complete response (excellent response) and incomplete response (indeterminate, biochemical, and structural incomplete response). The study developed classification tree to determine the optimum LNMs and LNR that predicted response to RAI. Multivariate logistic regression analyses were further analyzed to find independent factors of response to RAI. Result The mean age of patients was 44 ± 12 and 71.09% (873/1228) were females. The best cutoff value of LNMs to affect RAI treatment response determined by classification tree was 5. Further in 388 patients with LNMs >5, the best cutoff value of LNR to affect RAI treatment response determined by classification tree was 0.30. With multivariate analysis, the study found that LNMs (>5), gender, lymph node dissection, and American Thyroid Association (ATA) risk classification were independent predictors of response to RAI for all 1228 patients; and LNR (>0.30), gender, and ATA risk classification for 388 patients with LNMs >5. The sensitivity analysis indicated that whether patients with LNM or not were included, the multivariate logistic regression model was kept stable. On subgroup analysis, no significant interactions were observed between the effect of LNMs/LNR and gender, N stage, ATA risk classification, lymph node dissection, or T stage. Conclusions With classification tree, the study found that LNMs and LNR could predict initial response to RAI, and their optimal cutoff values were 5 and 0.30, separately.https://doi.org/10.1002/cam4.4288classification treedifferentiated thyroid cancerLNMsLNRradioactive iodine |
| spellingShingle | Canhua Yun Juan Xiao Jingjia Cao Chunchun Shao Lihua Wang Wei Zhang Hongying Jia Lymph node metastases >5 and metastatic lymph node ratio >0.30 of differentiated thyroid cancer predict response to radioactive iodine Cancer Medicine classification tree differentiated thyroid cancer LNMs LNR radioactive iodine |
| title | Lymph node metastases >5 and metastatic lymph node ratio >0.30 of differentiated thyroid cancer predict response to radioactive iodine |
| title_full | Lymph node metastases >5 and metastatic lymph node ratio >0.30 of differentiated thyroid cancer predict response to radioactive iodine |
| title_fullStr | Lymph node metastases >5 and metastatic lymph node ratio >0.30 of differentiated thyroid cancer predict response to radioactive iodine |
| title_full_unstemmed | Lymph node metastases >5 and metastatic lymph node ratio >0.30 of differentiated thyroid cancer predict response to radioactive iodine |
| title_short | Lymph node metastases >5 and metastatic lymph node ratio >0.30 of differentiated thyroid cancer predict response to radioactive iodine |
| title_sort | lymph node metastases 5 and metastatic lymph node ratio 0 30 of differentiated thyroid cancer predict response to radioactive iodine |
| topic | classification tree differentiated thyroid cancer LNMs LNR radioactive iodine |
| url | https://doi.org/10.1002/cam4.4288 |
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