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Prognostic value of lymph node ratio in metastatic papillary thyroid carcinoma

  • J Mansour (a1), D Sagiv (a1), E Alon (a1) (a2) and Y Talmi (a1) (a2)
Abstract
Objective:

Cervical metastases in papillary thyroid carcinoma are associated with increased recurrence. However, their effect on survival remains controversial. This study evaluated literature on the prognostic value of lymph node ratio for loco-regional recurrence and survival in metastatic papillary thyroid carcinoma.

Methods:

The PubMed database was systematically searched using the terms ‘papillary thyroid carcinoma’ and ‘lymph node ratio’. Articles addressing the association between lymph node ratio and loco-regional recurrence or survival were identified.

Results:

Nine retrospective studies were included, comprising 12 400 post-thyroidectomy and neck dissection papillary thyroid carcinoma patients (median age, 48.6 years; 76 per cent females). Lymph node ratio was associated with worse recurrence-free survival in 60 and 75 per cent of studies investigating the effect of central compartment metastases and both central and lateral compartment metastases on recurrence-free survival, respectively. One large population-based study showed an association between lymph node ratio and disease-specific mortality in N1 nodal disease, but failed to maintain the same association when N1b patients were excluded.

Conclusion:

Regional lymph node ratio is an independent predictor for loco-regional recurrence in pathologically staged N1 patients with papillary thyroid carcinoma. Patients with a high lymph node ratio should be closely followed up.

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Copyright
Corresponding author
Address for correspondence: Dr Jobran Mansour, Department of Otolaryngology, Head and Neck Surgery, Chaim Sheba Medical Center, Ramat-Gan 52621, Israel Fax: +972 (3)530 5124 E-mail: Jobran.h@gmail.com
References
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1 Shah, JP, Loree, TR, Dharker, D, Strong, EW, Begg, C, Vlamis, V. Prognostic factors in differentiated carcinoma of the thyroid gland. Am J Surg 1992;164:658–61
2 Davies, L, Welch, HG. Increasing incidence of thyroid cancer in the United States, 1973–2002. JAMA 2006;295:2164–7
3 Hundahl, SA, Fleming, ID, Fremgen, AM, Menck, HR. A National Cancer Data Base report on 53,856 cases of thyroid carcinoma treated in the U.S., 1985–1995. Cancer 1998;83:2638–48
4 Qubain, SW, Nakano, S, Baba, M, Takao, S, Aikou, T. Distribution of lymph node micrometastasis in pN0 well-differentiated thyroid carcinoma. Surgery 2002;131:249–56
5 Wada, N, Suganuma, N, Nakayama, H, Masudo, K, Rino, Y, Masuda, M et al. Microscopic regional lymph node status in papillary thyroid carcinoma with and without lymphadenopathy and its relation to outcomes. Langenbecks Arch Surg 2007;392:417–22
6 Baek, SK, Jung, KY, Kang, SM, Kwon, SY, Woo, JS, Cho, SH et al. Clinical risk factors associated with cervical lymph node recurrence in papillary thyroid carcinoma. Thyroid 2010;20:147–52
7 Sellers, M, Beenken, S, Blankenship, A, Soong, SJ, Turbat-Herrera, E, Urist, M et al. Prognostic significance of cervical lymph node metastases in differentiated thyroid cancer. Am J Surg 1992;164:578–81
8 Beasley, NJ, Lee, J, Eski, S, Walfish, P, Witterick, I, Freeman, JL. Impact of nodal metastases on prognosis in patients with well-differentiated thyroid cancer. Arch Otolaryngol Head Neck Surg 2002;128:825–8
9 Mazzaferri, EL, Young, RL. Papillary thyroid carcinoma: a 10 year follow-up report of the impact of therapy in 576 patients. Am J Med 1981;70:511–18
10 Zaydfudim, V, Feurer, ID, Griffin, MR, Phay, JE. The impact of lymph node involvement on survival in patients with papillary and follicular thyroid carcinoma. Surgery 2008;144:1070–7
11 Scheumann, GF, Gimm, O, Wegener, G, Hundeshagen, H, Dralle, H. Prognostic significance and surgical management of locoregional lymph node metastases in papillary thyroid cancer. World J Surg 1994;18:559–67
12 Podnos, YD, Smith, D, Wagman, LD, Ellenhorn, JD. The implication of lymph node metastasis on survival in patients with well-differentiated thyroid cancer. Am Surg 2005;71:731–4
13 Ricarte-Filho, J, Ganly, I, Rivera, M, Katabi, N, Fu, W, Shaha, A et al. Papillary thyroid carcinomas with cervical lymph node metastases can be stratified into clinically relevant prognostic categories using oncogenic BRAF, the number of nodal metastases, and extra-nodal extension. Thyroid 2012;22:575–84
14 Ceelen, W, Van Nieuwenhove, Y, Pattyn, P. Prognostic value of the lymph node ratio in stage III colorectal cancer: a systematic review. Ann Surg Oncol 2010;17:2847–55
15 Celen, O, Yildirim, E, Berberoglu, U. Prognostic impact of positive lymph node ratio in gastric carcinoma. J Surg Oncol 2007;96:95101
16 Slidell, MB, Chang, DC, Cameron, JL, Wolfgang, C, Herman, JM, Schulick, RD et al. Impact of total lymph node count and lymph node ratio on staging and survival after pancreatectomy for pancreatic adenocarcinoma: a large, population-based analysis. Ann Surg Oncol 2008;15:165–74
17 Roberts, TJ, Colevas, AD, Hara, W, Holsinger, FC, Oakley-Girvan, I, Divi, V. Number of positive nodes is superior to the lymph node ratio and American Joint Committee on Cancer N staging for the prognosis of surgically treated head and neck squamous cell carcinomas. Cancer 2016;122:1388–97
18 Schneider, DF, Chen, H, Sippel, RS. Impact of lymph node ratio on survival in papillary thyroid cancer. Ann Surg Oncol 2013;20:1906–11
19 Jeon, MJ, Yoon, JH, Han, JM, Yim, JH, Hong, SJ, Song, DE et al. The prognostic value of the metastatic lymph node ratio and maximal metastatic tumor size in pathological N1a papillary thyroid carcinoma. Eur J Endocrinol 2013;168:219–25
20 Lang, BH, Wong, KP, Wan, KY, Lo, CY. Significance of metastatic lymph node ratio on stimulated thyroglobulin levels in papillary thyroid carcinoma after prophylactic unilateral central neck dissection. Ann Surg Oncol 2012;19:1257–63
21 Schneider, DF, Mazeh, H, Chen, H, Sippel, RS. Lymph node ratio predicts recurrence in papillary thyroid cancer. Oncologist 2013;18:157–62
22 Ryu, IS, Song, CI, Choi, SH, Roh, JL, Nam, SY, Kim, SY. Lymph node ratio of the central compartment is a significant predictor for locoregional recurrence after prophylactic central neck dissection in patients with thyroid papillary carcinoma. Ann Surg Oncol 2014;21:277–83
23 Chang, YW, Kim, HS, Jung, SP, Kim, HY, Lee, JB, Bae, JW et al. Pre-ablation stimulated thyroglobulin is a better predictor of recurrence in pathological N1a papillary thyroid carcinoma than the lymph node ratio. Int J Clin Oncol 2016;21:862–8
24 Vas Nunes, JH, Clark, JR, Gao, K, Chua, E, Campbell, P, Niles, N et al. Prognostic implications of lymph node yield and lymph node ratio in papillary thyroid carcinoma. Thyroid 2013;23:811–16
25 Park, YM, Wang, SG, Shin, DH, Kim, IJ, Son, SM, Lee, BJ. Lymph node status of lateral neck compartment in patients with N1b papillary thyroid carcinoma. Acta Otolaryngol 2016;136:319–24
26 Lee, CW, Roh, JL, Gong, G, Cho, KJ, Choi, SH, Nam, SY et al. Risk factors for recurrence of papillary thyroid carcinoma with clinically node-positive lateral neck. Ann Surg Oncol 2015;22:117–24
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The Journal of Laryngology & Otology
  • ISSN: 0022-2151
  • EISSN: 1748-5460
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