Observational studyMedicine2016
Optimal Cut-Off Values of Lymph Node Ratio Predicting Recurrence in Papillary Thyroid Cancer.
Observational study in Medicine, 2016. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 16 papers.
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Who cites it
16 citing papers in PubMed.
- Treatment strategies for unilateral papillary thyroid carcinoma with ipsilateral cervical lymph node metastasis: a narrative review.Gland surgery · 2026Review
- Lymph-node ratio for micropapillary and nonmicropapillary differentiated thyroid cancers: a comprehensive analysis.Updates in surgery · 2025Article
- Pathological metastatic lymph node density (ND) predicts early recurrence in papillary thyroid cancer patients after curative resection.Gland surgery · 2025Article
- The Impact of Radioactive Iodine on Disease-Specific Survival in Low-to-Intermediate Risk N1b Papillary Thyroid Carcinoma.Annals of surgical oncology · 2025Article
- Demographic, clinical, and surgical features of patients undergoing thyroidectomy due to thyroid lesions in Southern Iran: A cross-sectional study.Health science reports · 2024Article
- Frozen section analysis of central lymph nodes in papillary thyroid cancer: the significance in determining the extent of surgery.Gland surgery · 2022Article
- Lymph node ratio is superior to AJCC N stage for predicting recurrence in papillary thyroid carcinoma.Endocrine connections · 2022Article
- Article
- Clinical Value of Lymph Node Ratio Integration with the 8Scientific reports · 2019Article
- Prognostic value of lymph nodes ratio in patients with stage III ovarian clear cell carcinoma: A retrospective study of patients in Southwest China.Journal of Cancer · 2019Article
- Prognostic Role of Metastatic Lymph Node Ratio in Papillary Thyroid Carcinoma.Journal of pathology and translational medicine · 2018Article
- Number of Metastatic Lymph Nodes and Ratio of Metastatic Lymph Nodes to Total Number of Retrieved Lymph Nodes Are Risk Factors for Recurrence in Patients With Clinically Node Negative Papillary Thyroid Carcinoma.Clinical and experimental otorhinolaryngology · 2018Article
- Latero-cervical lymph node metastases (N1b) represent an additional risk factor for papillary thyroid cancer outcome.Journal of endocrinological investigation · 2017Article
- Article
- Restratification of survival prognosis of N1b papillary thyroid cancer by lateral lymph node ratio and largest lymph node size.Cancer medicine · 2017Article
- Significance of micrometastases in the calculation of the lymph node ratio for papillary thyroid cancer.Annals of surgical treatment and research · 2017Article
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14 authors.
Funding
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Abstract
Regional lymph node (LN) metastasis has a significant impact for prediction of recurrence in patients with papillary thyroid cancers (PTC); however, the prognostic value of the lymph node ratio (LNR), which is defined as the ratio of the number of metastatic LNs to the total number of investigated LNs, is controversial. In this study, we determined the optimal cut-off values of LNRs for the prediction of recurrence in PTC patients.This large cohort study retrospectively evaluated 2294 patients who had undergone total thyroidectomy for PTC at a single institution from October 1985 to June 2009. The prediction probability of central LNR (cLNR, level VI) and total LNR (tLNR, levels II-VI) were estimated by binominal logistic regression analysis. Hazard ratios of the cut-off LNR values for cancer recurrence were calculated for relevant covariates using multivariate Cox regression analyses. Kaplan-Meier analyses were also utilized to assess the effects of estimated LNR cut-off values on recurrence-free survival (RFS).Of the 2294 patients, 138 (6.0%) presented cancer recurrence during the follow-up period (median duration = 107.1 months). The prediction probability indicated that LNRs of 0.4 and 0.5 for central LN and total LN, respectively, are optimal cut-off values for precise prediction with minimization of outliers. Multivariate Cox regression analyses revealed that cLNR ≥0.4 was independently predictive of recurrence in patients with N0 and N1a PTCs (hazard ratio [HR]: 7.016, 95% confidence interval [CI]: 3.72-12.986, P < 0.001) and that tLNR ≥0.5 indicated a significantly increased risk of recurrence in patients with N1b PTCs (HR: 2.372, 95% CI: 1.458-3.860, P < 0.001). In addition, Kaplan-Meier analyses clearly demonstrated that these LNR cut-off values are precisely operational in RFS estimation.The cut-off LNR values of 0.4 and 0.5 for cLNR and tLNR, respectively, were identified. Risk stratification combined with these LNR cut-off values may prove useful to determine treatment and follow-up strategies for PTC patients.
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