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Metastatic Lymph Node Ratio for Predicting Recurrence in Medullary Thyroid Cancer.

Jinyoung Kim¹, Jun Park¹, Hyunju Park¹

¹Division of Endocrinology and Metabolism, Department of Medicine, Thyroid Center, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul 06351, Korea.

|November 27, 2021

Summary

The lymph node ratio (LNR) can predict structural recurrence in medullary thyroid cancer (MTC). This quantitative tool helps assess lymph node metastasis risk in MTC patients, aiding in disease management.

Keywords:

lymph node ratio prognosis thyroid neoplasms

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Area of Science:

Oncology
Endocrinology
Surgical Pathology

Background:

The lymph node ratio (LNR) is a prognostic factor in various cancers, but its role in medullary thyroid cancer (MTC) requires further investigation.
Limited reports exist on the prognostic value of LNR in MTC, highlighting a gap in understanding its predictive capabilities for recurrence.

Purpose of the Study:

To evaluate the lymph node ratio (LNR) as a potential risk factor for structural recurrence in patients diagnosed with medullary thyroid cancer (MTC).
To assess the utility of LNR as a quantitative tool for evaluating lymph node metastasis in MTC.

Main Methods:

Retrospective review of medical records from 132 MTC patients treated between 1995 and 2017 at a single tertiary center.
LNR calculated as the ratio of metastatic lymph nodes to retrieved lymph nodes.
Univariable and multivariable Cox proportional hazard models used to identify predictors of structural recurrence, with recurrence-free survival as the endpoint.

Main Results:

Structural recurrence was observed in 39 patients over a median follow-up of 8.7 years.
Univariable analysis identified gross extrathyroidal extension, N stage, postoperative calcitonin, CEA, and LNR as significant predictors of recurrence (p < 0.05).
Multivariable analysis confirmed postoperative calcitonin, CEA, and LNR as significant predictors of disease-free survival (p < 0.05).

Conclusions:

The lymph node ratio (LNR) demonstrates potential as a valuable quantitative tool for predicting structural recurrence in medullary thyroid cancer (MTC).
Incorporating LNR assessment may enhance risk stratification and guide management strategies for MTC patients.
Further prospective studies are warranted to validate the prognostic significance of LNR in MTC.