An evaluation of lymph node yield and lymph node ratio in well-differentiated thyroid carcinoma

Shannon H. Beal, Steven L. Chen, Philip D Schneider, Steve R. Martinez

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Abstract

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 LNYand 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.

Original languageEnglish (US)
Pages (from-to)28-32
Number of pages5
JournalAmerican Surgeon
Volume76
Issue number1
StatePublished - Jan 2010

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Thyroid Neoplasms
Lymph Nodes
Survival
Thyroidectomy
Kaplan-Meier Estimate
Lymph Node Excision
Proportional Hazards Models
Epidemiology
Multivariate Analysis

ASJC Scopus subject areas

  • Surgery

Cite this

An evaluation of lymph node yield and lymph node ratio in well-differentiated thyroid carcinoma. / Beal, Shannon H.; Chen, Steven L.; Schneider, Philip D; Martinez, Steve R.

In: American Surgeon, Vol. 76, No. 1, 01.2010, p. 28-32.

Research output: Contribution to journalArticle

Beal, Shannon H. ; Chen, Steven L. ; Schneider, Philip D ; Martinez, Steve R. / An evaluation of lymph node yield and lymph node ratio in well-differentiated thyroid carcinoma. In: American Surgeon. 2010 ; Vol. 76, No. 1. pp. 28-32.
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