An Evaluation of Lymph Node Yield and Lymph Node Ratio in Well-Differentiated Thyroid Carcinoma

2010 ◽  
Vol 76 (1) ◽  
pp. 28-32 ◽  
Author(s):  
Shannon H. Beal ◽  
Steven L. Chen ◽  
Philip D. Schneider ◽  
Steve R. Martinez
Keyword(s):  
Lymph Node ◽  
Thyroid Carcinoma ◽  
Lymph Nodes ◽  
Lymph Node Ratio ◽  
Differentiated Thyroid Carcinoma ◽  
Lymph Node Yield ◽  
Node Negative ◽  
Node Ratio ◽  
Well Differentiated ◽  
Node Yield

It is unknown whether the number of lymph nodes harvested (lymph node yield, LNY) or the proportion of metastatic lymph nodes resected (metastatic lymph node ratio, MLNR) influence survival in well-differentiated thyroid carcinoma (WDTC). We hypothesized that overall survival in WDTC is influenced by the LNY and MLNR. We used the Surveillance, Epidemiology, and End Results database to identify all patients with primary, nonmetastatic WDTC who underwent thyroidectomy with at least one lymph node removed between 1988 and 2004. Kaplan-Meier survival curves for LNY and MLNR were compared using the log rank test. Multivariate Cox proportional hazards models included tumor and patient-specific factors. WDTC patients that met entry criteria totaled 9926. In the univariate model, LNY and MLNR had a significant impact on survival ( P < 0.001). In multivariate analysis, increasing LNY was associated with poorer survival in all patients ( P = 0.001) and node-negative patients ( P = 0.03), but not for node-positive patients ( P = 0.27). MLNR did not influence survival in node-positive patients ( P = 0.84). Among patients with WDTC treated with thyroidectomy and lymphadenectomy, increasing LNY and MLNR were associated with decreased survival. The decrease in survival associated with increasing LNY, even in node-negative patients, indicates that nodal understaging is inconsequential to WDTC survival.

scholarly journals Prognostic Implications of Lymph Node Yield and Lymph Node Ratio in Papillary Thyroid Carcinoma

Thyroid ◽  
2013 ◽  
Vol 23 (7) ◽  
pp. 811-816 ◽  
Author(s):  
Jonathan H. Vas Nunes ◽  
Jonathan R. Clark ◽  
Kan Gao ◽  
Elizabeth Chua ◽  
Peter Campbell ◽  
...  
Keyword(s):  
Lymph Node ◽  
Papillary Thyroid Carcinoma ◽  
Thyroid Carcinoma ◽  
Lymph Node Ratio ◽  
Papillary Thyroid ◽  
Lymph Node Yield ◽  
Node Ratio ◽  
Prognostic Implications ◽  
Node Yield

scholarly journals Role of lymph node yield and lymph node ratio in predicting outcomes in non-metastatic colorectal cancer

BJS Open ◽  
2018 ◽  
Vol 3 (1) ◽  
pp. 95-105 ◽  
Author(s):  
C. H. A. Lee ◽  
S. Wilkins ◽  
K. Oliva ◽  
M. P. Staples ◽  
P. J. McMurrick
Keyword(s):  
Colorectal Cancer ◽  
Lymph Node ◽  
Metastatic Colorectal Cancer ◽  
Lymph Node Ratio ◽  
Lymph Node Yield ◽  
Node Ratio ◽  
Node Yield

Lymph node ratio and survival for gastric cancer: A retrospective analysis of the SEER database

2009 ◽  
Vol 27 (15_suppl) ◽  
pp. 4561-4561
Author(s):  
R. Shridhar ◽  
G. W. Dombi
Keyword(s):  
Gastric Cancer ◽  
Multivariate Analysis ◽  
Lymph Node ◽  
Prognostic Factor ◽  
Lymph Nodes ◽  
Lymph Node Ratio ◽  
Seer Database ◽  
Node Negative ◽  
Node Ratio ◽  
Gastric Cancer Patients

4561 Purpose: To determine the prognostic significance of the lymph node ratio (ratio of number of positive lymph nodes to number of dissected lymph nodes) in gastric cancer patients. Methods: We retrospectively analyzed 10,176 gastric patients from 1990–2003 who underwent curative gastrectomy from the SEER database. Survival curves were calculated according to the Kaplan-Meier method and analyzed with log-rank test. Multivariate analysis of prognostic factors related to survival was performed by the Cox proportional hazard model. Results: The lymph node ratio (LNR) was a strong predictor of survival. LNR was equally predictive of survival whether the analysis was restricted to patients with <15 lymph nodes dissected or >15 lymph nodes dissected. Survival of patients with a LNR of 0.1–5% was not significantly different than node negative patients; however, survival of patients with a LNR of 5–10% was significantly different than node negative patients. Multivariate analysis showed that LNR, T-stage, tumor size, and number of lymph nodes positive were independent prognostic predictors of death and that LNR was the strongest predictor for death. Multivariate analysis showed that the number of lymph nodes dissected was an independent prognostic factor for survival. Moreover, LNR was an independent prognostic factor for N1 and N2 patients by AJCC staging. LNR trended toward significance in AJCC N3 patients. Conclusions: LNR was the strongest predictor of death in gastric cancer patients when compared to T-stage, number of lymph nodes positive, and tumor size. LNR is equally predictive regardless of the adequacy of the lymph node dissection. No significant financial relationships to disclose.

scholarly journals Lymph node ratio and liver metachronous metastases in colorectal cancer

2016 ◽  
Author(s):  
Giovanni Li Destri ◽  
Giuseppe Privitera ◽  
Gaetano La Greca ◽  
Roberto Scilletta ◽  
Antonio Pesce ◽  
...  
Keyword(s):  
Colorectal Cancer ◽  
Lymph Node ◽  
Lymph Nodes ◽  
Liver Metastases ◽  
Lymph Node Ratio ◽  
Statistical Significance ◽  
Node Negative ◽  
Lymph Node Sampling ◽  
Node Ratio ◽  
Selection Of

Abstract Objective The authors seek to assess whether the LNR could predict the risk of metachronous liver metastases. Background data Using the goal of sampling 12 lymph nodes for a proper staging of colorectal cancer is often "uncommon" and the lymph node ratio (LNR) is what allows for a better prognosis selection of patients. Methods A homogeneous group of 280 patients, followed-up for at least 5 years, was evaluated. In order to highlight the groups with the highest risk of metachronous liver metastases, patients were divided into four quartiles groups in relation to the LNR. Results The number of lymph nodes sampled in group "stage I" was significantly lower. Even if statistical significance between the global LNR and the development of liver metastases has not been reached, the subdivision into quartiles has made it possible to highlight that in the more advanced ratio groups, a higher incidence of metachronous liver metastases (p &lt;0.028) was registered and was a different distribution of patients with or without liver metastasis in function of quartiles (P =0.01). Conclusions The LNR has enabled us to prognosticate patients who are at greater risk of developing metachronous liver metastases. The lower lymph node sampling in the patients with less advanced staging (I) and in patients with node-negative cancer (I+II) who developed liver metastases, leads us to believe that some patients have been understaged. We believe that the LNR, especially in cases of adequate lymph node sampling, is a useful gauge to better sub-stratify "node-positive" patients.

Risk Factors and Outcomes of Postoperative Recurrent Well-Differentiated Thyroid Cancer: A Single Institution’s 15-Year Experience

2020 ◽  
Vol 162 (4) ◽  
pp. 469-475 ◽  
Author(s):  
Shaunak N. Amin ◽  
Justin R. Shinn ◽  
Mark M. Naguib ◽  
James L. Netterville ◽  
Sarah L. Rohde
Keyword(s):  
Risk Factors ◽  
Thyroid Cancer ◽  
Lymph Node ◽  
Lymph Nodes ◽  
Differentiated Thyroid Cancer ◽  
Metastatic Lymph Node ◽  
Lymph Node Yield ◽  
Well Differentiated ◽  
Node Yield ◽  
Positive Lymph Nodes

Objective Identify risk factors and outcomes of recurrent well-differentiated thyroid cancer. Study Design Retrospective case-control analysis. Setting Tertiary care academic center in Nashville, Tennessee. Subjects and Methods This single-center analysis reviews 478 patients who underwent initial surgical management of well-differentiated thyroid carcinoma between 2002 and 2017. Patients were dichotomized with or without recurrent well-differentiated thyroid cancer. Demographic and clinicopathologic risk factors were carefully reviewed. Univariate, multiple regression, and survival analyses were used to evaluate predictors of recurrence. Results Thirty-eight patients (7.9%) who received initial surgical intervention for well-differentiated thyroid carcinoma at our institution recurred, with an average time to recurrence of 24 months. Male sex, tumor size, multifocality, extrathyroidal extension, lymphovascular invasion, number of positive lymph nodes, and low lymph node yield were all significantly associated with locoregional recurrence ( P < .05). Multiple regression analysis showed that extrathyroidal extension, number of positive lymph nodes, and low lymph node yield were independent factors predictive of posttreatment recurrence ( P < .05). Metastatic lymph node ratio, the ratio of positive lymph nodes extracted to lymph node yield, of ≥0.3 is associated with increased risk of recurrence ( P < .001) and decreased 5-year recurrence free survival ( P < .001). Conclusion Extrathyroidal extension, number of positive lymph nodes, and low lymph node yield are independent clinicopathologic risk factors for postoperative recurrence of well-differentiated thyroid cancer. Metastatic lymph node ratio is uncommonly used but can be an important prognosticator of recurrence. Patients with metastatic lymph node ratio ≥0.3 should be counseled on their increased risk of recurrence and should undergo close surveillance following surgery.

Lymph node yield and lymph node ratio in oral cavity and oropharyngeal carcinoma: Preliminary results from a prospective, multicenter, international cohort

Oral Oncology ◽  
2020 ◽  
Vol 107 ◽  
pp. 104740 ◽  
Author(s):  
Oreste Iocca ◽  
Pasquale Di Maio ◽  
Armando De Virgilio ◽  
Raul Pellini ◽  
Paweł Golusiński ◽  
...  
Keyword(s):  
Lymph Node ◽  
Oral Cavity ◽  
Lymph Node Ratio ◽  
Oropharyngeal Carcinoma ◽  
Lymph Node Yield ◽  
Preliminary Results ◽  
Node Ratio ◽  
Node Yield
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