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Predictive value of metastatic cervical lymph node ratio in papillary thyroid carcinoma recurrence
Author(s) -
Yip Jonathan,
Orlov Steven,
Orlov David,
Vaisman Alon,
Hernández Karen Gómez,
Etarsky Daniel,
Kak Ipshita,
Parvinnejad Nikoo,
Freeman Jeremy L.,
Walfish Paul G.
Publication year - 2013
Publication title -
head and neck
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.012
H-Index - 127
eISSN - 1097-0347
pISSN - 1043-3074
DOI - 10.1002/hed.23047
Subject(s) - medicine , lymph , lymph node , thyroid carcinoma , receiver operating characteristic , odds ratio , cervical lymph nodes , thyroidectomy , confidence interval , radiology , retrospective cohort study , oncology , thyroid , metastasis , pathology , cancer
Background The purpose of this study was to determine whether the proportion of metastatic cervical lymph nodes resected (metastatic lymph node ratio [MLNR]) predicted papillary thyroid carcinoma (PTC) recurrence, and whether MLNR could alter the predictive ability of TNM nodal classification for recurrence in PTC. Methods We conducted a retrospective review of patients with PTC who underwent a total or near‐total thyroidectomy with at least 1 lymph node removed at our institution. Results Of 253 patients, 35 (13.8%) developed recurrent disease. The total MLNR (ratio between total metastatic lymph nodes and total number of lymph nodes resected) independently predicted PTC recurrence (odds ratio [OR], 1.024; 95% confidence interval [CI], 1.010–1.039; p = .001). In receiver operating characteristic (ROC) curve analysis, TNM nodal classification with total MLNR had greater accuracy in predicting PTC recurrence than did TNM nodal classification alone (0.726 and 0.675, respectively). Conclusion MLNR is an independent predictor of PTC recurrence and enhances the predictive value of TNM nodal classification. © 2012 Wiley Periodicals, Inc. Head Neck, 2013