Amit M, et al. - The authors intended to discern the prognostic role of lymph node density (LND) in papillary thyroid cancer (PTC). Herein, the reproducibility of LND was illustrated as a predictor of outcomes in PTC. It was also disclosed that lymph node density exhibited the ability to possibly assist in detecting the patients with poorer survival who could gain an advantage from more aggressive adjuvant therapy.

Methods

• The medical records of patients with PTC who were treated at the University of Texas MD Anderson Cancer Center were re-analyzed between January 1, 2000, and December 31, 2015.
• With the aid of the Kaplan-Meier method, the survival and recurrence outcomes were computed.
• Significant variables on univariate analysis were subjected to a Cox proportional hazards regression multivariate model.
• Disease-specific survival (DSS) constituted the primary outcome.
• Other measurements included overall survival (OS).

Results

• Data from 2,542 patients (1801 [71%] male; median age, 48 years [range, 18-97 years]) with a median follow-up of 55 months (range, 4-192 months) were analyzed.
• The 10-year disease-specific survival rate was discovered to be 98% for patients with LND of 0.19 or less, compared with 90% for those with LND greater than 0.19 (effect size, 8%; 95% CI, 4%-15%).
• The findings revealed that the 10-year overall survival was 87% for patients with LND of 0.19 or less, in contrast to 79%, for patients with LND greater than 0.19 (effect size, 8%; 95% CI, 3%-15%).
• As found in the multivariable analysis, LND greater than 0.19 exhibited an independent connection with an adverse DSS (hazard ratio [HR], 4.11; 95% CI, 2.11-8.97) and OS (HR, 1.96; 95% CI, 1.24-4.11).
• LND greater than 0.19 remained a significant marker for DSS (HR, 2.94; 95% CI, 1.36-9.81) and OS (HR, 2.26; 95% CI, 1.12-5.34) was demonstrated by the subgroup analysis of patients with 18 or more lymph nodes analyzed.
• Compared with the traditional TNM staging system, the inclusion of LND into the current American Joint Committee on Cancer staging system successfully stratified risk groups.