Lymph node ratio predicts recurrence in pediatric papillary thyroid cancer

Area of Science:

• Oncology
• Pediatric Surgery
• Pathology

Background:

• Regional lymph node metastasis is crucial for predicting recurrence in papillary thyroid cancer (PTC).
• The lymph node ratio (LNR) is a validated predictor in adults but unstudied in pediatric PTC.
• This study investigates LNR's prognostic value in pediatric PTC recurrence.

Purpose of the Study:

• To evaluate the lymph node ratio (LNR) as a predictor of recurrence in pediatric patients with papillary thyroid cancer (PTC).
• To assess LNR's utility in stratifying recurrence risk after specific surgical interventions for PTC in children.

Main Methods:

• Retrospective analysis of pediatric patients (≤21 years) with PTC between 2002-2014.
• Inclusion criteria: total thyroidectomy with central or unilateral neck dissection and ≥24 months follow-up.
• LNR calculated as metastatic to total lymph nodes; recurrence analyzed based on LNR cutoff of 0.45.

Main Results:

• Forty-eight pediatric patients met criteria; 32 underwent TTpCND, 16 TTMRND.
• For TTpCND, recurrence was 25% with LNR >0.45 vs. 4.2% with LNR ≤0.45.
• For TTMRND, recurrence was 100% with LNR >0.45 vs. 30.8% with LNR ≤0.45 (p=0.03).

Conclusions:

• Lymph node ratio (LNR) shows potential as a prognostic predictor for recurrence in pediatric PTC.
• LNR may aid in risk stratification for pediatric patients undergoing specific surgical procedures for PTC.
• Further studies with larger cohorts are warranted to confirm LNR's predictive value in pediatric PTC.