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Prognostic value of lymph node ratio in children and adolescents with papillary thyroid cancer
Author(s) -
Xu Yangmengyuan,
Wang Yu,
Zhang Xinyue,
Huang Rui,
Tian Rong,
Liu Bin
Publication year - 2021
Publication title -
clinical endocrinology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.055
H-Index - 147
eISSN - 1365-2265
pISSN - 0300-0664
DOI - 10.1111/cen.14491
Subject(s) - medicine , papillary thyroid cancer , neck dissection , thyroid cancer , lymph node , thyroidectomy , cancer , thyroid , univariate analysis , retrospective cohort study , population , multivariate analysis , gastroenterology , oncology , environmental health
Objective Neck lymph node (LN) metastasis is a common feature of paediatric papillary thyroid cancer, and LN ratio (LNR) is defined as the ratio of the number of positive LNs excised to the total number of removed. Unlike in adults, few data are available regarding the clinical implication of LNR in the paediatric population. Our purpose was to investigate the association of LNR with clinical outcomes in paediatric papillary thyroid cancer. Design & Methods The study retrospectively reviewed 136 consecutive children and adolescents with papillary thyroid cancer and LN involvement but no initial distant metastasis. Initial treatment, included in all patients a total thyroidectomy with central and/or lateral neck dissection followed by radioactive iodine ablation. Within the neck dissections, total number of LNs removed, total positive LNs and LN ratios were determined. The effect of clinicopathologic characteristics and intraoperative findings on persistent and recurrent diseases were analysed by univariate and multivariate analyses. Results Median number of positive LNs was 9, and median LNR was 0.4. During a median follow‐up of 49 months (range, 12.0‐139 months), persistent disease occurred in 43 (31.6%) patients. The multivariable analysis showed that age and LNR were the independent factors predictive of persistent disease. Patients with a LNR >0.34 exhibited a threefold higher risk of persistent disease after initial therapy than the counterparts ( P = .02). Conclusion Our findings suggest that LNR was an independent determinant predictive of persistent disease after initial therapy in children and adolescents with papillary thyroid cancer.