Significance of micrometastases in the calculation of the lymph node ratio for papillary thyroid cancer.
10.4174/astr.2017.92.3.117
- Author:
Young Woo CHANG
1
;
Hwan Soo KIM
;
Seung Pil JUNG
;
Hoon Yub KIM
;
Jae Bok LEE
;
Jeoung Won BAE
;
Gil Soo SON
Author Information
1. Department of Breast Endocrine Surgery, Korea University College of Medicine, Seoul, Korea. gsson@korea.ac.kr
- Publication Type:Original Article
- Keywords:
Papillary thyroid carcinoma;
Lymph nodes
- MeSH:
Humans;
Lymph Nodes*;
Methods;
Neck;
Neoplasm Micrometastasis*;
Prognosis;
Recurrence;
ROC Curve;
Thyroglobulin;
Thyroid Gland*;
Thyroid Neoplasms*;
Thyroidectomy
- From:Annals of Surgical Treatment and Research
2017;92(3):117-122
- CountryRepublic of Korea
- Language:English
-
Abstract:
PURPOSE: The lymph node ratio (LNR) is an important prognostic factor in papillary thyroid carcinoma (PTC), but micrometastases in cervical lymph nodes (LNs) are not of great clinical importance. In this study, we analyzed the accuracy of prediction of the prognosis depending on whether micrometastases were included in the number of metastatic LNs when calculating LNR. METHODS: The study included 353 PTC patients who underwent total thyroidectomy with neck LN dissection, and calculated LNR by 2 methods according to whether micrometastases were included in the number of metastatic LNs: Method 1 did not and method 2 did include. To compare the predictive values of LNR by the 2 methods, correlation coefficients and receiver operating characteristic (ROC) curves were analyzed. RESULTS: Positive correlations were found between LNR and preablation stimulated thyroglobulin (sTg) levels in both methods, but the correlation between method 1 LNR and preablation sTg level was significantly stronger than that for method 2 (Fisher z = 1.7, P = 0.045). The areas under these 2 independent ROC curves were analyzed; the prognostic efficacy of method 1 LNR was more accurate than that of method 2 LNR, and the difference was statistically significant (P = 0.0001). CONCLUSION: Regional recurrence of PTC can be predicted more accurately by not including micrometastases in the number of metastatic LNs when calculating LNR.
