Lymph node ratio predicts recurrence in pediatric papillary thyroid cancer
| Autor: | Catherine A. Dinauer, Raffaella A. Morotti, Jill C. Rubinstein, Emily R. Christison-Lagay, Kayleigh Herrick-Reynolds, Glenda G. Callender |
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| Rok vydání: | 2019 |
| Předmět: |
Adult
Male medicine.medical_specialty Adolescent medicine.medical_treatment Unilateral modified radical neck dissection Metastasis Papillary thyroid cancer Young Adult 03 medical and health sciences 0302 clinical medicine 030225 pediatrics medicine Humans Thyroid Neoplasms Child Lymph node Retrospective Studies Total thyroidectomy business.industry Small sample Neck dissection General Medicine Prognosis medicine.disease Survival Analysis medicine.anatomical_structure Thyroid Cancer Papillary Lymphatic Metastasis 030220 oncology & carcinogenesis Pediatrics Perinatology and Child Health Thyroidectomy Neck Dissection Female Surgery Lymph Nodes Radiology Neoplasm Recurrence Local business Pediatric population |
| Zdroj: | Journal of Pediatric Surgery. 54:129-132 |
| ISSN: | 0022-3468 |
| DOI: | 10.1016/j.jpedsurg.2018.10.010 |
| Popis: | Background Regional lymph node (LN) metastasis at the time of presentation plays a significant role in predicting recurrence in patients with papillary thyroid cancer (PTC). Multiple studies in the adult population have demonstrated that the lymph node ratio (LNR) in both the central and lateral neck can improve the accuracy of recurrence prediction, but this ratio has not been studied in the pediatric population. In this study, we sought to investigate the LNR in the central and lateral compartments as a prognostic predictor for recurrence in pediatric patients with PTC. Methods A retrospective analysis of pediatric patients (≤ 21 years old) at a single institution between 2002 and 2014 who underwent total thyroidectomy with prophylactic central neck dissection (TTpCND) with at least 3 sampled nodes or total thyroidectomy with unilateral modified radical neck dissection (TTMRND) with at least 10 sampled nodes, and on whom at least 24 months of follow up data were available was performed. The LNR was defined as the ratio of metastatic LNs to total number of investigated LNs. Recurrence after TTpCND and TTMRND was examined separately as a function of LNR, using the value of 0.45 as a cutoff. Results Forty-eight patients met inclusion criteria. Thirty-two underwent TTpCND, and sixteen underwent TTMRND. Median age at time of operation was 17 years (range 6–20), and median duration of follow-up was 53.5 months (range 24–183). In the TTpCND, LNR ranged from 0 to 1.0. There were two recurrences among the eight patients (25%) undergoing TTpCND in patients with LNRs > 0.45 and a single recurrence among the 24 patients (4.2%) undergoing TTpCND with an LNR ≤ 0.45. In the TTMRND, LNR ranged from 0.1 to 1.0. There were 3 recurrences in 12 patients with LNR ≤ 0.45 (30.8%%) and 4 recurrences in 4 patients with LNR > 0.45 (100%) (p = 0.03). Conclusions Although limited by small sample size, LNR may be a useful predictor to stratify the likelihood of recurrence in pediatric patients undergoing TTpCND or TTMRND for pathologic N1a or N1b PTC. Type of study Prognosis study / retrospective case series. Level of evidence Level IV. |
| Databáze: | OpenAIRE |
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