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Related Experiment Video

Updated: May 14, 2026

"Sun's Seven-Step Technique" for Endoscopic En-Bloc Resection of Thyroid Cancer via the Chest-Breast Approach
07:45

"Sun's Seven-Step Technique" for Endoscopic En-Bloc Resection of Thyroid Cancer via the Chest-Breast Approach

Published on: November 28, 2025

Lymph node ratio predicts recurrence in papillary thyroid cancer.

David F Schneider1, Haggi Mazeh, Herbert Chen

  • 1Department of Surgery, University of Wisconsin, K3/739 Clinical Science Center, 600 Highland Avenue, Madison, WI 53792, USA. schneiderd@surgery.wisc.edu

The Oncologist
|January 25, 2013
PubMed
Summary

The lymph node ratio (LNR) can predict papillary thyroid cancer (PTC) recurrence. Elevated LNR and central LNR (cLNR) indicate a higher risk of disease recurrence after initial PTC treatment.

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Area of Science:

  • Oncology
  • Surgical Pathology

Background:

  • Papillary thyroid cancer (PTC) frequently presents with lymph node metastasis (20%-50% of cases).
  • The prognostic significance of lymph node metastases in PTC remains debated.
  • This study investigates the predictive value of the lymph node ratio (LNR) for disease recurrence in PTC.

Purpose of the Study:

  • To evaluate the lymph node ratio (LNR) and central lymph node ratio (cLNR) as predictors of disease recurrence in papillary thyroid cancer (PTC).
  • To determine if LNR can stratify patients based on their risk of PTC recurrence.
  • To inform postoperative follow-up strategies for PTC patients.

Main Methods:

  • Retrospective review of 217 PTC patients who underwent total thyroidectomy (2005-2010).
  • Calculation of total LNR (positive nodes/total nodes) and cLNR.

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Last Updated: May 14, 2026

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  • Use of regression analysis to identify LNR thresholds for recurrence prediction and multivariate analysis to assess LNR's independent effect on recurrence, alongside Kaplan-Meier and log-rank tests for disease-free survival.

    • Main Results:

    • Sixteen (23.2%) patients experienced disease recurrence.
    • Significantly worse disease-free survival was observed in patients with total LNR ≥0.7 (p < .01) or cLNR ≥0.86 (p = .04).
    • LNR was a significant independent predictor of recurrence (OR: 19.5, 95% CI: 4.1-22.9; p < .01).

    Conclusions:

    • Elevated total LNR and cLNR are strongly associated with PTC recurrence post-surgery.
    • LNR serves as a valuable tool for predicting recurrence risk in PTC patients.
    • LNR can guide postoperative management and follow-up intensity for individuals with PTC.