Predictive value of metastatic cervical lymph node ratio in papillary thyroid carcinoma recurrence.
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).


CONCLUSIONS
MLNR is an independent predictor of PTC recurrence and enhances the predictive value of TNM nodal classification.
Department of Medicine, Endocrine Division, University of Toronto, Toronto, Ontario, Canada.
Jonathan
J
Yip
Steven
S
Orlov
David
D
Orlov
Alon
A
Vaisman
Karen Gómez
KG
Hernández
Daniel
D
Etarsky
Ipshita
I
Kak
Nikoo
N
Parvinnejad
Jeremy L
JL
Freeman
Paul G
PG
Walfish
D000328:Adult; D002291:Carcinoma, Papillary / Q000473:pathology* / Q000601:surgery; D005260:Female; D006801:Humans; D008198:Lymph Nodes / Q000473:pathology* / Q000601:surgery; D008207:Lymphatic Metastasis; D008297:Male; D008875:Middle Aged; D037981:Neck Dissection; D009364:Neoplasm Recurrence, Local / Q000473:pathology* / Q000601:surgery; D011237:Predictive Value of Tests; D011379:Prognosis; D012189:Retrospective Studies; D013961:Thyroid Gland / Q000473:pathology* / Q000601:surgery; D013965:Thyroidectomy / Q000379:methods*