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. 2023 Jan 19;15(3):624.
doi: 10.3390/cancers15030624.

Clinical Significance of the Lymph Node Ratio of the Second Operation to Predict Re-Recurrence in Thyroid Carcinoma

Joonseon Park  1 , Il Ku Kang  1 , Ja Seong Bae  1 , Jeong Soo Kim  1 , Kwangsoon Kim  1
Affiliations

Clinical Significance of the Lymph Node Ratio of the Second Operation to Predict Re-Recurrence in Thyroid Carcinoma

Joonseon Park et al. Cancers (Basel). .

Abstract

The purpose of this study was to establish the risk factors for re-recurrences and disease-specific mortality (DSM) in recurrent thyroid cancer. Patients with recurrent thyroid cancer who underwent initial thyroid surgery from January 2000 to December 2019 at Seoul St. Mary's Hospital (Seoul, Korea) were assessed. Clinicopathological characteristics and long-term oncologic outcomes were compared between patients with one recurrence (n = 202) and patients with re-recurrences (n = 44). Logistic regression and cox-regression analyses were conducted to determine the risk factors for re-recurrences and DSM, respectively. Receiver-operating characteristic curve analysis was performed to determine the cutoff value for lymph node ratio (LNR) as a predictor of re-recurrences. DSM was significantly higher in the re-recurrence group compared with the single-recurrence group (6.8% vs. 0.5%, p = 0.019). Surgical treatment at the first recurrence significantly lowered the risk of re-recurrences. Age (≥55), male sex, and LNR (≥0.15) were independent significant risk factors for re-recurrences in patients who underwent surgery at the first recurrence. Surgical resection is the optimal treatment for initial thyroid cancer recurrence. LNR at re-operation is more effective in predicting re-recurrence than the absolute number of metastatic LNs.

Keywords: lymph node ratio; mortality risk; papillary thyroid carcinoma; re-recurrence; recurrence risk.

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Conflict of interest statement

The authors declare no conflict of interest.

Figures

Figure 1
Figure 1
Re-recurrence-free survival curves according to the management at the first recurrence (log-rank p = 0.045).
Figure 2
Figure 2
Disease-specific survival curves according to the management at the first recurrence (log-rank p = 0.002).
Figure 3
Figure 3
Receiver-operator characteristic curves for lymph node ratio and the number of positive lymph nodes.
Figure 4
Figure 4
Re-recurrence-free survival curves according to the lymph node ratio cutoff of 0.15 (log-rank p = 0.015).
See this image and copyright information in PMC

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