Value of lymph node ratio as a prognostic factor of recurrence in medullary thyroid cancer

PeerJ

article

Weijing Hao¹  Jingzhu Zhao¹  Fengli Guo¹  Pengfei Gu¹  Jinming Zhang¹  Dongmei Huang¹  Xianhui Ruan¹  Yu Zeng¹  Xiangqian Zheng¹  Ming Gao¹ 

[1] Department of Thyroid and Neck Tumor, Tianjin Medical University Cancer Institute and Hospital, National Clinical Research Center for Cancer, Key Laboratory of Cancer Prevention and Therapy, Tianjin’s Clinical Research Center for Cancer;Department of Thyroid and Breast Surgery, Binzhou Medical University Hospital;Department of Thyroid and Breast Surgery, Tianjin Union Medical Center;Tianjin Key Laboratory of General Surgery in Construction, Tianjin Union Medical Center

关键词: Medullary thyroid cancer;    Lymph node ratio;    Metastatic lymph node;    Resected lymph node;    Disease-free survival;    Overall survival;   

DOI  :  10.7717/peerj.15025

学科分类：社会科学、人文和艺术（综合）

来源: Inra

【 摘 要 】

Background and Objectives The purpose of this study is to evaluate the relationship between lymph node status (the number of resected lymph nodes; the number of metastatic lymph nodes, LNM, and lymph node ratio, LNR) and biochemical recurrence, disease-free survival (DFS), as well as overall survival (OS) in medullary thyroid carcinoma (MTC). Methods This study enrolled MTC patients at Tianjin Medical University Cancer Institute and Hospital between 2011 and 2019. We used Logistic regression analysis, Cox regression models and Kaplan-Meier test to identify risk factors influencing biochemical recurrence, DFS, and OS. Results We identified 160 patients who satisfied the inclusion criteria from 2011 to 2019. We used ROC analysis to define the cut-off value of LNR with 0.24. Multifocality, preoperative calcitonin levels, pathologic N stage, resected lymph nodes, LNM, LNR, and the American Joint Committee on Cancer (AJCC) clinical stage were significant (P < 0.05) prognostic factors influencing biochemical cure. In univariable analyses, gross extrathyroidal extension, preoperative calcitonin levels, pathologic T classification, pathologic N stage, resected lymph nodes, LNM, LNR, AJCC clinical stage, and biochemical cure were significant (P < 0.05) factors of DFS. When the multivariable analysis was performed, LNR was identified as predictor of DFS (HR = 4.818, 95% CI [1.270–18.276]). Univariable Cox regression models reflected that tumor size, pathologic N stage, and LNR were predictor of OS. Furthermore, multivariable analysis manifested that LNR was predictor of OS (HR = 10.061, 95% CI [1.222–82.841]). Conclusions This study illustrated that LNR was independent prognostic factor of DFS and OS in MTC. In addition, LNR influenced biochemical cure. Further investigations are needed to determine the optimal cut-off value for predicting prognosis.

【 授权许可】

CC BY