Predictive value of metastatic lateral lymph node ratio for recurrence in pathologically lateral lymph node‐positive papillary thyroid cancer patients with palpable lymph nodes

Dong, Wenwu; Horiuchi, Kiyomi; Noguchi, Eiichiro; Okamoto, Takahiro

doi:10.1002/hed.27067

Cited by 4 publications

(1 citation statement)

References 37 publications

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“…Dong et al . 19 reported that a PLR of at least 50% in the lateral neck was associated with poor RFS in PTC. In addition, Noel and Orloff 20 suggested that patients with postoperatively evaluated stimulated Tg (indicating persistent disease) had a lower LNY and a higher PLR during their initial neck dissection.…”

Section: Discussionmentioning

confidence: 99%

The lymph node yield in the initial lateral neck dissection predicts recurrence in the lateral neck of papillary thyroid carcinoma: a revision surgery cohort study

Wei

et al. 2023

International Journal of Surgery

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Background: This study aimed to evaluate the relationship between lateral lymph node yield (LLNY) and the ratio of lateral positive lymph nodes to lymph node yield (LPLR) from initial lateral neck dissection (LND) in patients with papillary thyroid carcinoma (PTC), as well as the risk of recurrence in patients undergoing LND reoperations. Methods: This retrospective cohort study enrolled patients with PTC who underwent revision LND between 1 January 2012, and 31 December 2021. The initial and revised clinical data were retrieved. Patient demographics, clinicopathological features, clinical records, and follow-up information were also reviewed. LLNY and LPLR were determined during the initial LND. Results: In total, 156 patients with PTC were included in this study, with a median follow-up of 36.5 months; 107 had recurrent lateral neck disease. The optimal LLNY and LPLR cutoff values for recurrent/persistent disease were 24.5 and 32.74%, respectively. The high-risk group (LLNY<25) had the lowest recurrence-free survival rate compared with to moderate-risk group (LLNY≥25, LPLR≥32.74%) and low-risk group (LLNY≥25, LPLR<32.74%) (P<0.001). The moderate-risk group had lower recurrence-free survival than the low-risk group. Multivariate analysis revealed that an LLNY less than 25 in the initial LND was an independent risk factor for recurrence/persistence of lateral neck (P<0.001). Conclusions: This study identified that LLNY and LPLR were associated with recurrence/persistence in PTC patients at the time of revision surgery was performed.

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Section: Discussionmentioning

confidence: 99%

The lymph node yield in the initial lateral neck dissection predicts recurrence in the lateral neck of papillary thyroid carcinoma: a revision surgery cohort study

Wei

et al. 2023

International Journal of Surgery

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Utility of Lymph Node Ratio in Predicting Biochemical Incomplete Clinical Response in Patients with Papillary Ca thyroid with Positive Neck Node

Gontu,

Das,

Rahman

et al. 2024

Indian J Otolaryngol Head Neck Surg

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Association of Lymph Nodes Positive Rate With the Risk of Recurrence in Patients With Stage T1 Papillary Thyroid Cancer

Qin,

Cai,

Yin

et al. 2024

Journal of the Endocrine Society

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The incidence of lymph node metastasis in papillary thyroid carcinoma (PTC) is common and a significant risk factor for local recurrence; however, its impact on recurrence patterns among low-risk patients remains uncertain. We aimed to elucidate the effect of metastatic lymph node on recurrence type. The medical records of 1209 patients with stage T1 PTC who underwent unilateral thyroidectomy with ipsilateral central lymph node dissection were retrospectively analyzed. The study first identified risk factors for different types of recurrence and then categorized patients as high or low risk based on their lymph node positive ratio (LNPR). The diagnostic accuracy of LNPR in predicting recurrence was compared using receiver operating characteristic (ROC) curve analysis, while differences in recurrence-free survival were assessed using the Kaplan-Meier method. During follow-up, a total of 502(41.5%) patients had central lymph node metastasis and 52 (4.3%) patients experiencing recurrence. Notably, LNPR was significantly higher in relapsed patients compared to non-relapsed patients, with mean values of 0.45 and 0.23, respectively (P<0.001). The recurrence rate of residual thyroid did not differ significantly across different T stages (P=0.679), N stages (P=0.415), or LNPR risk groups (P=0.175). However, the recurrence rate of lymph nodes showed a significant correlation with LNPR (P<0.001). The area under the ROC curves for LNPR risk stratification at 5 and 10 years were approximately 0.691 and 0.634, respectively, both of which outperformed N-stage. The findings underscore the significance of LNPR's reliability as a prognostic indicator for local lymph node recurrence in patients diagnosed with T1 stage PTC.

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Predictive value of metastatic lateral lymph node ratio for recurrence in pathologically lateral lymph node‐positive papillary thyroid cancer patients with palpable lymph nodes

Cited by 4 publications

References 37 publications

The lymph node yield in the initial lateral neck dissection predicts recurrence in the lateral neck of papillary thyroid carcinoma: a revision surgery cohort study

The lymph node yield in the initial lateral neck dissection predicts recurrence in the lateral neck of papillary thyroid carcinoma: a revision surgery cohort study

Utility of Lymph Node Ratio in Predicting Biochemical Incomplete Clinical Response in Patients with Papillary Ca thyroid with Positive Neck Node

Association of Lymph Nodes Positive Rate With the Risk of Recurrence in Patients With Stage T1 Papillary Thyroid Cancer

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