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Lymph node yield independently predicts local recurrence in papillary thyroid cancer.
Zihao M Yang1, Alexander Papachristos1,2, Anthony J Gill1,3,4
1Faculty of Medicine and Health, Northern Clinical School, Sydney Medical School, University of Sydney, Sydney, New South Wales, Australia.
World Journal of Surgery
|November 12, 2024
Summary
Lymph node yield (LNY) in papillary thyroid cancer (PTC) surgery is linked to recurrence. Achieving >3 lymph nodes in central and >20 in lateral dissections indicates adequate surgical resection, reducing recurrence risk.
Area of Science:
- Endocrine Surgery
- Surgical Oncology
- Thyroid Cancer Research
Background:
- Lymph node yield (LNY) is a quality metric in colorectal cancer surgery.
- No established LNY guidelines exist for papillary thyroid cancer (PTC) central and lateral compartment dissections.
- This study investigates LNY's association with regional recurrence in PTC.
Purpose of the Study:
- To assess the relationship between lymph node yield and regional recurrence in PTC patients.
- To establish threshold LNY values for adequate compartmental lymphadenectomy in PTC surgery.
Main Methods:
- Retrospective analysis of 1992-2022 patient data from The University of Sydney Endocrine Surgery Unit database.
- Inclusion of patients undergoing prophylactic or therapeutic central or lateral compartment dissection for PTC.
- Multivariate logistic regression to analyze the link between nodal yield and local recurrence.
Main Results:
- A central LNY of ≤3 was an independent adverse prognostic factor for central recurrence (OR 2.19).
- A lateral LNY of ≤20 was independently predictive of lateral recurrence (OR 2.45).
Conclusions:
- Lymph node yield is associated with local recurrence in papillary thyroid cancer.
- Suggested minimum LNY thresholds are >3 for central and >20 for lateral compartments.
- Further multi-center research is recommended to validate these findings.
