Lymph node density in papillary thyroid carcinoma is a prognostic factor after adjusting for pathological stage

Area of Science:

• Oncology
• Pathology
• Surgical Oncology

Background:

• Papillary thyroid carcinoma (PTC) is the most common thyroid malignancy.
• Accurate prognostic factors are crucial for tailoring treatment and predicting patient outcomes.
• The role of lymph node density (LND) in PTC survival needs further clarification.

Purpose of the Study:

• To investigate the association between lymph node density and survival in differentiated PTC.
• To determine if LND is an independent predictor of survival, adjusted for pathological stage.
• To validate findings using the 8th edition of the TNM classification.

Main Methods:

• Retrospective analysis of 543 PTC patients.
• Restaging according to the 8th edition TNM classification.
• Calculation of LND as the ratio of positive to total excised lymph nodes.
• Univariate and multivariate analyses using log-rank tests and Cox proportional hazards models.

Main Results:

• In patients with pN1bM0 (n=150), LND ≥ 0.3 was significantly associated with shorter disease-specific survival (DSS).
• Across all 543 patients, LND ≥ 0.3 was significantly linked to shorter overall survival (OS) and DSS.
• Multivariate analysis confirmed LND as an independent prognostic factor.

Conclusions:

• Lymph node density is a valuable prognostic indicator in differentiated papillary thyroid carcinoma.
• LND ≥ 0.3 predicts poorer survival outcomes, including overall and disease-specific survival.
• LND can be utilized alongside the 8th edition TNM staging for improved prognostic assessment.