Clinical Significance of the Lymph Node Ratio of the Second Operation to Predict Re-Recurrence in Thyroid Carcinoma

Park, Joonseon; Kang, Il Ku; Bae, Ja Seong; Kim, Jeong Soo; Kim, Kwangsoon

doi:10.3390/cancers15030624

Cited by 4 publications

(3 citation statements)

References 48 publications

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“…Regarding PTC with between one and five pathologic LNs examined, we have two conflicting perspectives; The PTC may not be aggressive because only one to five metastatic LNs were identified, while PTC with a low LNY is related to a lesser extent of surgical resection, which means a higher rate of recurrence. We recently performed retrospective studies regarding LNR in PTC and recurrent thyroid cancer [19,20], and we wondered if LNR is associated with the prognosis of patients with PTC when a small number of LNs are examined.…”

Section: Discussionmentioning

confidence: 99%

Lymph Node Ratio Predicts Recurrence in Patients with Papillary Thyroid Carcinoma with Low Lymph Node Yield

Kang

Park

Bae

et al. 2023

Cancers

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The American Thyroid Association risk stratification system suggests that having >5 metastatic lymph nodes (LNs) increase the recurrence risk in patients with papillary thyroid carcinoma (PTC). However, little is known about PTC with <5 harvested LNs. This study aimed to stratify patients with low-LN-yield (low-LNY) PTC based on lymph node ratios (LNRs). From 2007 to 2017, 6317 patients who underwent thyroidectomies were diagnosed with PTC at Seoul St. Mary’s Hospital, and 909 patients with low LNYs were included in the study. Tumor recurrence was compared based on LNR. The LNR cutoff was determined using a receiver operating characteristic curve. Forty-six patients (5.1%) experienced recurrences over a mean follow-up period of 127.24 ± 33.6 months (range, 5–190 months). The cutoff for the low-LNR (n = 675) and high-LNR (n = 234) groups was 0.29 (AUC = 0.676, 95% CI = 0.591–0.761, p < 0.001). The recurrence rate was significantly higher in the high-LNR group compared to the rate in the low-LNR group (12.4% vs. 2.5%, p < 0.001). Multivariate analysis using Cox regression revealed that tumor size and LNR ≥ 0.29 were independent prognostic factors for recurrence. Therefore, LNR can be utilized to stratify the risk of recurrence in patients with low-LNY PTC.

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Section: Discussionmentioning

confidence: 99%

Lymph Node Ratio Predicts Recurrence in Patients with Papillary Thyroid Carcinoma with Low Lymph Node Yield

Kang

Park

Bae

et al. 2023

Cancers

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“…In this study, these nodal factors were associated with recurrence, which is consistent with the findings of previous studies. Non-initial treatment patients lack information regarding their initial LNM status, which may affect the accuracy of prognosis predictions based solely on the number of metastatic LNs ( 12 ). As such, LNR and ENE may serve as more appropriate indicators for assessing the risk of recurrence.…”

Section: Discussionmentioning

confidence: 99%

“…However, the predictive value of genetic features remains controversial ( 10 ). Except these risk factors proposed in the guidelines, recent studies have investigated some lymph node metastasis (LNM)–related factors for predicting patient outcomes, such as the number of metastatic lymph nodes and the metastatic lymph node ratio ( 11 , 12 ). To date, no prediction model has combined novel risk factors with previously established risk factors from the guidelines.…”

Section: Introductionmentioning

confidence: 99%

Risk factors and predictive model for recurrence in papillary thyroid carcinoma: a single-center retrospective cohort study based on 955 cases

Li,

Tian,

Jiang

et al. 2023

Front. Endocrinol.

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BackgroundThe 2015 American Thyroid Association guidelines proposed recurrence risk stratification of differentiated thyroid carcinoma, including papillary thyroid carcinoma (PTC), but this stratification excluded non–initial treatment patients with worse outcomes. This study aimed to explore the potential risk factors for recurrence in PTC and develop a predictive model for both initial and non–initial treatment of patients with PTC.MethodsA total of 955 patients were included in this study. Differences between the recurrence (−) and recurrence (+) groups were compared. The 955 patients were randomized into two groups: the training group (671 cases) and the validation group (284 cases). All variables were selected using the LASSO regression analysis. A nomogram was developed based on the results of the univariate and multivariate logistic regression analyses. The nomogram performance was evaluated using discrimination and calibration.ResultsPatients aged ≥55 years, extranodal extension (ENE), metastatic LN ratio (LNR) >0.5, and non–initial treatment were identified as potential risk factors for recurrence through LASSO regression and univariate and multivariate analyses. The receiver operating characteristic curve (ROC curve) showed high efficiency, with an area under the ROC curve (AUC) of 0.819 (95% confidence interval [CI], 0.729–0.909) and 0.818 (95% CI, 0.670–0.909) in the training and validation groups, respectively. The calibration curve indicated that the nomogram had a good consistency.ConclusionIn patients with PTC, age ≥55 years, ENE, LNR >0.5, and non–initial treatment are potential risk factors for recurrence. The predictive model of recurrence was confirmed to be a practical and convenient tool for clinicians to accurately predict PTC recurrence.

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Bioinformatics analysis for the identification of Sprouty-related EVH1 domain-containing protein 3 expression and its clinical significance in thyroid carcinoma

Zhang,

Meng,

Wang

et al. 2024

Sci Rep

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The poorly differentiated thyroid carcinoma (THCA) subtype is associated with an aggressive disease course, a less favorable overall prognosis, and an increased risk of distant organ metastasis. In this study, our objective was to explore the potential utility of the Sprouty-related EVH1 domain-containing protein 3 (SPRED3) as a biomarker for early diagnosis and prognosis in THCA patients. The differentially expressed prognostic-related genes associated with THCA were identified by querying The Cancer Genome Atlas (TCGA) database. The difference in the expression of the SPRED3 gene between thyroid carcinoma (THCA) tissues and normal tissues was analyzed using data from The Cancer Genome Atlas (TCGA) and further validated through immunohistochemistry. Univariate and multivariate Cox regression models were used, along with clinical information from THCA patients, to analyze the prognostic value of the SPRED3 gene in THCA patients. Functional enrichment analysis was subsequently performed to elucidate the molecular mechanisms underlying the regulatory effects of the SPRED3 gene on thyroid carcinoma. Additionally, we calculated the percentage of infiltrating immune cells in THCA patients and evaluated their correlation with SPRED3 gene expression. Compared with those in noncancerous thyroid tissue, the gene and protein expression levels of SPRED3 were found to be elevated in thyroid carcinoma tissues. Furthermore, the expression of SPRED3 in thyroid carcinoma exhibited significant correlations with tumor location, histological grade, pathological stage, and tumor node metastasis classification (TNM) stage. Univariate and multivariate Cox proportional hazards (Cox) regression analyses demonstrated that SPRED3 could serve as an independent prognostic factor for predicting the overall survival of THCA patients. The results of functional enrichment analysis suggested the potential involvement of SPRED3 in the regulation of extracellular matrix organization, epidermal development, signaling receptor activator activity, skin development, receptor ligand activity, glycosaminoglycan binding, neuroactive ligand‒receptor interaction, the IL-17 signaling pathway, and the PI3K-Akt signaling pathway. Additionally, there were significant correlations between the expression level of the SPRED3 gene and the infiltration of various immune cells (eosinophils, central memory T cells, neutrophils, macrophages, and NK cells) within the thyroid tumor microenvironment. SPRED3 can be used as a prognostic biomarker in patients with THCA could potentially be therapeutic target for THCA.

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Clinical Significance of the Lymph Node Ratio of the Second Operation to Predict Re-Recurrence in Thyroid Carcinoma

Cited by 4 publications

References 48 publications

Lymph Node Ratio Predicts Recurrence in Patients with Papillary Thyroid Carcinoma with Low Lymph Node Yield

Lymph Node Ratio Predicts Recurrence in Patients with Papillary Thyroid Carcinoma with Low Lymph Node Yield

Risk factors and predictive model for recurrence in papillary thyroid carcinoma: a single-center retrospective cohort study based on 955 cases

Bioinformatics analysis for the identification of Sprouty-related EVH1 domain-containing protein 3 expression and its clinical significance in thyroid carcinoma

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