ArticleLangenbeck's archives of surgery2023
Lymph node ratio as a tool to stratify patients with N1b papillary thyroid cancer.
Article in Langenbeck's archives of surgery, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 3 papers.
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Who cites it
3 citing papers in PubMed.
- ATA 2015-2025 risk stratification transition: prognostic significance of N1b disease in papillary thyroid carcinoma with limited nodal burden.The oncologist · 2026Article
- Functional and in silico evidence for the role of microRNAs 148a-5p and 199a in migration and invasion of papillary thyroid carcinoma cells.Discover oncology · 2025Article
- Pathological metastatic lymph node density (ND) predicts early recurrence in papillary thyroid cancer patients after curative resection.Gland surgery · 2025Article
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Authors and funding
6 authors.
Funding
Abstract
backgroundThe prognostic significance of lymph node ratio (LNR) in N1b papillary thyroid cancer is unclear. Therefore, the impact of LNR on disease-specific mortality (DSM) and overall survival (OS) in patients with N1b papillary thyroid cancer (PTC) needs to be defined.
methodsWe used the Surveillance, Epidemiology, and End Results (SEER) database of patients who had undergone thyroidectomy and lymph node dissection. Factors associated with DSM and OS were analyzed and identified using univariate and multivariate Cox proportional risk models. X-tile software was used to find the best cutoff value of LNR. Kaplan-Meier estimates for DSM were plotted for LNR and were compared with the log-rank test. The ROC curve evaluated the validity of the model.
resultsA total of 3223 patients with N1b PTC were identified in the SEER database between 1975 and 2019. The best cutoff value for LNR was 0.6. The multivariate Cox proportional risk model showed that age, race, T3/T4 classification, distant metastasis, extent of surgery, number of metastatic lymph nodes, and LNR > 0.6 were independent risk factors for DSM (all p < 0.05). Age, sex, T4 classification, distant metastasis, extent of surgery, and LNR > 0.6 were independent risk factors for OS (all p < 0.05). The Kaplan-Meier method plotted a cumulative risk curve and showed that patients with LNR > 0.6 had a significantly higher risk of DSM than patients with LNR ≤ 0.6 (p = 0.002).
conclusionLNR was a powerful predictor of DSM and OS in N1b PTC patients. LNR could be a useful tool for the stratification of PTC patients with lateral neck metastases.
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