Central lymph node ratio is an important recurrence prognostic factor for pediatric differentiated thyroid cancer

Area of Science:

• Pediatric Endocrinology
• Oncology
• Surgical Pathology

Background:

• Pediatric Differentiated Thyroid Carcinoma (DTC) exhibits high recurrence rates, necessitating improved risk stratification.
• Current methods are inadequate for accurately assessing recurrence risk in young patients.
• Investigating novel clinicopathological factors is crucial for enhancing pediatric DTC management.

Purpose of the Study:

• To evaluate the Central Lymph Node Ratio (CLNR) as a predictor of recurrence in pediatric DTC.
• To identify clinicopathological factors associated with recurrence in pediatric DTC patients.
• To improve risk stratification for pediatric DTC to optimize treatment strategies.

Main Methods:

• Retrospective review of 100 pediatric DTC patients (age ≤19) treated between 2012-2021.
• Analysis of clinicopathological variables and univariate logistic regression to identify recurrence predictors.
• Kaplan-Meier survival analysis to assess the significance of identified factors.

Main Results:

• The CLNR, with a cutoff of 77.78%, significantly predicted recurrence in pediatric DTC.
• Patients with CLNR >77.78% had a 5.467-fold increased risk of recurrence.
• High CLNR group associated with male gender, clinical lymph node positivity (cN1), and extrathyroidal extension (ETE).

Conclusions:

• The CLNR is a valuable tool for predicting recurrence and stratifying risk in pediatric DTC.
• High CLNR warrants aggressive treatment, including iodine-131 therapy and TSH suppression.
• Proactive surveillance is recommended for early detection of recurrence in high-risk pediatric DTC patients.