scholarly journals Preoperative serum inflammation-based scores in medullary thyroid cancer

2021 ◽  
Author(s):  
Ana Figueiredo ◽  
Susana Esteves ◽  
Margarida Maria Moura ◽  
Pedro Marques ◽  
Joana Simões-Pereira ◽  
...  
Keyword(s):  
Thyroid Cancer ◽  
Lymph Node ◽  
Lymph Node Metastasis ◽  
Distant Metastasis ◽  
Medullary Thyroid Cancer ◽  
Univariate Analysis ◽  
Extrathyroidal Extension ◽  
Medullary Thyroid ◽  
Lymphocyte Ratio ◽  
Node Metastasis

Abstract Introduction: Neutrophil-to-lymphocyte ratio (NLR), platelet-to-lymphocyte ratio (PLR) and systemic immune-inflammation index (SII) are prognostic factors in several tumours, however little is known in medullary thyroid cancer (MTC). Objective: To evaluate the association between preoperative NLR, PLR and SII with MTC clinicopathological and molecular features, and their predictive value for lymph-node and distant metastasis. Methods: We retrospectively analysed 75 patients with MTC who underwent surgery at our institution. Results: In our cohort, 56% were females, the median age at diagnosis was 57 years (44–69), the median tumour diameter was 25mm (15–50); 21.3% were multifocal and 34.7% had extrathyroidal extension. Fibrosis was present in 30 of the 37 analysed samples; RET somatic status was assessed in 35 cases and 21 harboured a mutation. Lymph-node and distant metastasis were observed in 36 (48.0%) and 8 (10.7%), respectively. Higher NLR was associated with preoperative calcitonin, angioinvasion, extrathyroidal extension, moderate/severe fibrosis; higher PLR was associated to extrathyroidal extension and advanced T stages; lower SII and NLR were associated with biochemical cure after surgery. Increased PLR, NLR and SII were associated with advanced MTC stages. In the univariate analysis, only NLR was associated with lymph-node metastasis (odds ratio (OR) = 2.69, 95% confidence interval (CI): 1.50–5.84; p = 0.004); however, in the multivariate model, NLR was no longer a predictive factor for lymph-node metastasis. Conclusion: None of these serum inflammatory markers predicted the occurrence of distant metastasis. In conclusion, NLR, PLR and SII may indicate aggressive MTC disease, but do not predict lymph-node or distant metastasis.

scholarly journals Usefulness of Pre-Thyroidectomy Neutrophil-Lymphocyte, Platelet-Lymphocyte, and Monocyte-Lymphocyte Ratios in Discriminating Lymph Node and Distant Metastases in Differentiated Thyroid Cancer

2021 ◽  
Author(s):  
Cinthia Minatel Riguetto ◽  
Icléia Siqueira Barreto ◽  
Frederico Fernandes Ribeiro Maia ◽  
Ligia Vera Montali da Assumpção ◽  
Denise Engelbrecht Zantut-Wittmann
Keyword(s):  
Thyroid Cancer ◽  
Lymph Node ◽  
Lymph Node Metastasis ◽  
Distant Metastasis ◽  
Differentiated Thyroid Cancer ◽  
Response To Therapy ◽  
Lymphocyte Ratio ◽  
Node Metastasis ◽  
Disease Free ◽  
Active Disease

Abstract Purpose This study aims to show the relationship between neutrophil-lymphocyte ratio (NLR), platelet-lymphocyte ratio (PLR) and monocyte-lymphocyte ratio (MLR), with clinicopathological characteristics in patients with differentiated thyroid cancer (DTC). Methods This is a retrospective study involving 390 DTC patients who had complete blood cell count available at the time of the surgery. NLR, PLR, and MLR were calculated, risk of cancer-related death, structural recurrence, and response to therapy were assessed by the 8th edition of the tumor-node-metastasis (TNM), American Thyroid Association (ATA) Risk Stratification System, and ATA Response to Therapy Reclassification, respectively. Results PLR was higher in distant metastasis (133.15±43.95 vs 119.24±45.69, p = 0.0345), lower in disease-free versus persistent disease or death (117.72±44.70 vs 131.07±47.85, p = 0.0089). In MLR, patients ≥55 had a higher score than < 55 years old (0.26±0.10 vs 0.24±0.12, p = 0.0379). Higher MLR (OR 8.775; 95% CI = 1.532–50.273; p = 0.0147), intermediate (OR 4.892; 95% CI = 2.492–9.605; p ≤ 0.0001) and high ATA risks (OR 5.998; 95% CI = 3.126–11.505; p ≤ 0.0001) were risk factors associated with active disease. NLR was not significant. ROC curve cut-off values for NLR, PLR, and MLR were able to discriminate distant from lymph node metastasis (NLR > 1.93 sensitivity 73.3%, specificity 58.7%; PLR > 124.34 sensitivity 86.7%, specificity 69.2%; MLR > 0.21 sensitivity 80%, specificity 45.2%). Conclusion Cut-off values of NLR, PLR, and MLR discriminated the presence of distant metastasis from lymph node metastasis with good sensitivity and accuracy. PLR was an associated factor with disease-free status and higher in DTC patients with distant metastasis, persistency, and disease-related death. MLR was a risk factor of active disease.

scholarly journals Patients with familial non-medullary thyroid cancer have an outcome similar to that of patients with sporadic papillary thyroid tumors

2011 ◽  
Vol 55 (3) ◽  
pp. 219-223 ◽  
Author(s):  
Fabián Pitoia ◽  
Graciela Cross ◽  
María E. Salvai ◽  
Erika Abelleira ◽  
Hugo Niepomniszcze
Keyword(s):  
Thyroid Cancer ◽  
Lymph Node ◽  
Lymph Node Metastasis ◽  
Medullary Thyroid Cancer ◽  
Papillary Thyroid ◽  
Clinical Behavior ◽  
Medullary Thyroid ◽  
Persistent Disease ◽  
Node Metastasis ◽  
Baseline Characteristics

OBJECTIVE:The purpose of this study was to determine whether familial non-medullary thyroid cancer (FNMTC) is more aggressive than sporadic thyroid cancer. SUBJECTS AND METHODS: We compared the clinical behavior and outcome of 16 subjects with FNMTC from 7 unrelated kindred with those observed in 160 subjects with sporadic PTC (SPTC) from our database. RESULTS: The only different baseline characteristics observed between both groups were: bilateral malignancy, 38% vs. 24%, respectively (p = 0.03), and lymph node metastasis, 56.2% vs. 39%, respectively (p = 0.01). Considering the outcome, in the FNMTC, 9 (56.2%) patients were rendered free of disease, one patient died from thyroid cancer (6%), and 6/16 (37.5%) had persistent disease. In the SPTC Group, 87 (54%) patients were considered free of disease, 11 (7%) died due to PTC, and 62 (38%) had persistent disease (p = ns). CONCLUSIONS: Despite the higher incidence of lymph node metastasis in FNMTC patients this situation seemed not to alter the compared outcome.

Prognostic Use of Pretreatment Hematologic Parameters in Patients Receiving Definitive Chemoradiotherapy for Cervical Cancer

2016 ◽  
Vol 26 (6) ◽  
pp. 1169-1175 ◽  
Author(s):  
Cem Onal ◽  
Ozan C. Guler ◽  
Berna A. Yildirim
Keyword(s):  
Cervical Cancer ◽  
Multivariate Analysis ◽  
Lymph Node ◽  
Lymph Node Metastasis ◽  
Univariate Analysis ◽  
Definitive Chemoradiotherapy ◽  
Lymphocyte Ratio ◽  
Node Metastasis ◽  
Cell Counts ◽  
Potential Biomarker

ObjectivesThe aim of this work was to evaluate the prognostic role of pretreatment neutrophil-to-lymphocyte ratio (NLR) and platelet-to-lymphocyte ratio (PLR) in recipients of definitive chemoradiotherapy (ChRT) for cervical cancer.MethodsIn 235 patients given definitive ChRT for histologically confirmed cervical cancer, clinical data and pretreatment complete blood cell counts were analyzed. Prognostic and therapeutic ramifications of NLR and PLR were assessed.ResultsMedian pretreatment NLR and PLR were 3.03 (range, 1.04–13.03) and 133.02 (range, 36.3–518.16), respectively. Both NLR and PLR correlated significantly with tumor size, lymph node metastasis, and treatment response. In addition to NLR and PLR, tumor stage, size, and nodal metastasis were identified by univariate analysis as significant predictors of overall survival (OS) and progression-free survival (PFS). By multivariate analysis, independent predictors of OS and PFS were NLR (OS: hazard ratio [HR], 3.322; 95% confidence interval [CI], 1.905–5.790; PFS: HR, 3.579; 95% CI, 2.106–6.082; both P < 0.001) and lymph node metastasis (OS: HR, 2.620; 95% CI, 1.706–4.023; PFS: HR, 2.989; 95% CI, 1.918–4.378; both P < 0.001), although patients’ age (HR, 1.019; 95% CI, 1.003–1.035; P = 0.02) was also significantly predictive of OS.ConclusionsPretreatment NLR and PLR were associated with larger tumors, lymph node metastasis, and poorer therapeutic responses to definitive ChRT. By multivariate analysis, pretreatment NLR and lymph node metastasis were found independently predictive of OS and PFS, whereas patients’ age was significantly predictive of OS only. In patients with advanced cervical cancer, NLR is a potential biomarker, serving to guide systemic therapy and predict treatment outcomes.

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