Prognostic value of lymph node ratio in metastatic papillary thyroid carcinoma

Cervical metastases in papillary thyroid carcinoma are associated with increased recurrence. However, their effect on survival remains controversial. This study evaluated literature on the prognostic value of lymph node ratio for loco-regional recurrence and survival in metastatic papillary thyroid...

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Bibliographic Details
Published in:Journal of laryngology and otology 2018-01, Vol.132 (1), p.8-13
Main Authors: Mansour, J, Sagiv, D, Alon, E, Talmi, Y
Format: Article
Language:English
Subjects:
Biopsy
Carcinoma, Papillary - diagnosis
Carcinoma, Papillary - epidemiology
Carcinoma, Papillary - secondary
Committees
Disease-Free Survival
Dissection
Global Health
Humans
Incidence
Lymph
Lymph nodes
Lymph Nodes - pathology
Lymphatic Metastasis
Lymphatic system
Medical prognosis
Metastases
Metastasis
Mortality
Neck
Papillary thyroid carcinoma
Population studies
Prognosis
Review Articles
Studies
Survival
Survival Rate - trends
Thyroid
Thyroid cancer
Thyroid Cancer, Papillary
Thyroid Neoplasms - diagnosis
Thyroid Neoplasms - epidemiology
Thyroid Neoplasms - secondary
Thyroidectomy
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Summary:Cervical metastases in papillary thyroid carcinoma are associated with increased recurrence. However, their effect on survival remains controversial. This study evaluated literature on the prognostic value of lymph node ratio for loco-regional recurrence and survival in metastatic papillary thyroid carcinoma. The PubMed database was systematically searched using the terms 'papillary thyroid carcinoma' and 'lymph node ratio'. Articles addressing the association between lymph node ratio and loco-regional recurrence or survival were identified. Nine retrospective studies were included, comprising 12 400 post-thyroidectomy and neck dissection papillary thyroid carcinoma patients (median age, 48.6 years; 76 per cent females). Lymph node ratio was associated with worse recurrence-free survival in 60 and 75 per cent of studies investigating the effect of central compartment metastases and both central and lateral compartment metastases on recurrence-free survival, respectively. One large population-based study showed an association between lymph node ratio and disease-specific mortality in N1 nodal disease, but failed to maintain the same association when N1b patients were excluded. Regional lymph node ratio is an independent predictor for loco-regional recurrence in pathologically staged N1 patients with papillary thyroid carcinoma. Patients with a high lymph node ratio should be closely followed up.
ISSN:0022-2151
1748-5460
DOI:10.1017/S0022215117002250