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. 2023 Mar 22:14:1132687.
doi: 10.3389/fendo.2023.1132687. eCollection 2023.

Log odds of negative lymph nodes/T stage ratio (LONT): A new prognostic tool for differentiated thyroid cancer without metastases in patients aged 55 and older

Xuezhen Wang  1   2 , Yufan Wu  1   2 , Xiaoxia Li  1   2 , Jinsheng Hong  1   2   3 , Mingwei Zhang  1   2   3
Affiliations

Log odds of negative lymph nodes/T stage ratio (LONT): A new prognostic tool for differentiated thyroid cancer without metastases in patients aged 55 and older

Xuezhen Wang et al. Front Endocrinol (Lausanne). .

Abstract

Background: The optimal approach to assess the postoperative status of lymph nodes in differentiated thyroid cancer (DTC) remains controversial. Our aim was to determine if the log odds of negative lymph nodes/T stage ratio (LONT) could serve as a new prognostic and predictive tool for DTC without metastases in patients aged ≥ 55 years.

Methods: The Surveillance, Epidemiology, and End Results (SEER) database was used to study the role of LONT in patients aged ≥55 years diagnosed with DTC without metastases. The primary outcome was overall survival (OS). The Kaplan-Meier method and the Cox proportional hazard regression model were used to calculate the outcome. Moreover, the robustness of research findings was evaluated using sensitivity analyses.

Results: A total of 21,172 DTC patients aged ≥55 years without distant metastasis were enrolled. Multivariate Cox regression analyses and a "floating absolute risk" analysis showed that a LONT ≥0.920 (vs. -0.56 to 0.92) was a protective factor for OS in DTC patients. Sensitivity analyses revealed an E-value of 1.98 for the obtained LONT value. In subgroup analyses, LONT was correlated significantly with OS in different subgroups of negative lymph nodes, stage-I-II subgroups and the N0 subgroup. The conditional probability of survival of DTC improved with prolonged survival time in the LONT ≥0.920 group.

Conclusion: A high LONT was associated with longer OS compared with low LONT in patients aged ≥55 years with non-metastatic DTC. LONT could provide valuable information for undertaking postoperative evaluations.

Keywords: DTC; LONT; negative lymph nodes; negative lymph nodes/T stage; prognosis.

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Conflict of interest statement

The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest.

Figures

Figure 1
Figure 1
Kaplan–Meier plot for overall survival (OS) for LONT (A), age (B), sex (C), ethnicity (D), marital status (E), stage (based on AJCC system) (F), T stage (based on AJCC system) (G), N (based on AJCC system) (H), tumor grade (I), tumor diameter (J), histology type (K), sequence number (L), multiple primary tumors (M), NLNs (N), chemotherapy (O), and radiotherapy (P) of patients with differentiated thyroid cancer without metastases aged 55 years and older.
Figure 2
Figure 2
Univariate Cox regression analyses and multivariate Cox regression analyses for LONT and clinical features. Forest plot of hazard ratios demonstrating the results of Cox regression analyses. The dashed line denotes where HR = 1.
Figure 3
Figure 3
The conditional probability of survival of LONT ≥0.920 (A), -0.586≤ LONT<0.920 (B), and LONT<-0.586 (C).
See this image and copyright information in PMC

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