Pre-RAI Monocyte-to-Lymphocyte Ratio Predicts Early and Higher Recurrence Risk in Intermediate-Risk DTC, While PNI...

Area of Science:

• Oncology
• Hematology
• Endocrinology

Background:

• Differentiated thyroid carcinoma (DTC) has a good prognosis, but recurrence is a concern, particularly in intermediate-risk cases.
• Current risk stratification relies on tumor factors, neglecting the host's immune and nutritional status.
• Hematological indices offer a potential avenue to assess the host's capacity to combat tumor progression.

Purpose of the Study:

• To evaluate the prognostic value of systemic inflammatory and nutritional markers in predicting recurrence risk in intermediate-risk DTC patients.
• To assess if hematological indices can refine existing risk stratification models for DTC.
• To identify simple, accessible markers for personalized patient follow-up.

Main Methods:

• Retrospective analysis of 282 intermediate-risk DTC patients with excellent/indeterminate response post-treatment and >3 years follow-up.
• Calculation of nine hematological indices from blood samples taken before radioactive iodine (RAI) administration.
• Statistical analysis including ROC, logistic regression, and Kaplan-Meier survival analysis.

Main Results:

• The monocyte-to-lymphocyte ratio (MLR) was the most effective hematological index in predicting recurrence (AUC: 0.70).
• High pre-RAI MLR was an independent predictor of recurrence (OR=4.94) and shorter recurrence-free survival (HR=3.01).
• Tumor size, vascular invasion, and lymph node metastases also independently predicted recurrence; nutritional indices showed no prognostic value.

Conclusions:

• Pre-RAI MLR is a simple and valuable marker for refining recurrence risk stratification in intermediate-risk DTC.
• Incorporating MLR can aid in personalizing follow-up strategies for these patients.
• Further research may validate MLR's role in clinical decision-making for DTC management.