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Optimal Cut-Off Values of Lymph Node Ratio Predicting Recurrence in Papillary Thyroid Cancer

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dc.contributor.author강상욱-
dc.contributor.author김민지-
dc.contributor.author김태형-
dc.contributor.author남기현-
dc.contributor.author반은정-
dc.contributor.author이슬기-
dc.contributor.author이잔디-
dc.contributor.author이초록-
dc.contributor.author정웅윤-
dc.contributor.author정종주-
dc.contributor.author조영석-
dc.contributor.author최정범-
dc.contributor.author허준-
dc.date.accessioned2017-02-24T03:22:36Z-
dc.date.available2017-02-24T03:22:36Z-
dc.date.issued2016-
dc.identifier.issn0025-7974-
dc.identifier.urihttps://ir.ymlib.yonsei.ac.kr/handle/22282913/146331-
dc.description.abstractRegional 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.-
dc.description.statementOfResponsibilityopen-
dc.formatapplication/pdf-
dc.languageEnglish-
dc.publisherLippincott Williams & Wilkins-
dc.relation.isPartOfMEDICINE-
dc.rightsCC BY-NC-ND 2.0 KR-
dc.rights.urihttps://creativecommons.org/licenses/by-nc-nd/2.0/kr/-
dc.subject.MESHAdolescent-
dc.subject.MESHAdult-
dc.subject.MESHAged-
dc.subject.MESHCarcinoma/epidemiology-
dc.subject.MESHCarcinoma/pathology*-
dc.subject.MESHCarcinoma, Papillary-
dc.subject.MESHFemale-
dc.subject.MESHHumans-
dc.subject.MESHLymph Nodes/pathology*-
dc.subject.MESHLymphatic Metastasis-
dc.subject.MESHMale-
dc.subject.MESHMiddle Aged-
dc.subject.MESHNeoplasm Recurrence, Local/epidemiology*-
dc.subject.MESHPredictive Value of Tests-
dc.subject.MESHRepublic of Korea/epidemiology-
dc.subject.MESHRetrospective Studies-
dc.subject.MESHThyroid Neoplasms/epidemiology-
dc.subject.MESHThyroid Neoplasms/pathology*-
dc.subject.MESHYoung Adult-
dc.titleOptimal Cut-Off Values of Lymph Node Ratio Predicting Recurrence in Papillary Thyroid Cancer-
dc.typeArticle-
dc.publisher.locationUnited States-
dc.contributor.collegeCollege of Medicine-
dc.contributor.departmentDept. of Surgery-
dc.contributor.googleauthorSeul Gi Lee-
dc.contributor.googleauthorJoon Ho-
dc.contributor.googleauthorJung Bum Choi-
dc.contributor.googleauthorTae Hyung Kim-
dc.contributor.googleauthorMin Jhi Kim-
dc.contributor.googleauthorEun Jeong Ban-
dc.contributor.googleauthorCho Rok Lee-
dc.contributor.googleauthorSang-Wook Kang-
dc.contributor.googleauthorJong Ju Jeong-
dc.contributor.googleauthorKee-Hyun Nam-
dc.contributor.googleauthorSang Geun Jung-
dc.contributor.googleauthorYoung Suk Jo-
dc.contributor.googleauthorJandee Lee-
dc.contributor.googleauthorWoong Youn Chung-
dc.identifier.doi10.1097/MD.0000000000002692-
dc.contributor.localIdA00032-
dc.contributor.localIdA04524-
dc.contributor.localIdA01083-
dc.contributor.localIdA01245-
dc.contributor.localIdA01782-
dc.contributor.localIdA04626-
dc.contributor.localIdA03066-
dc.contributor.localIdA03256-
dc.contributor.localIdA03674-
dc.contributor.localIdA03722-
dc.contributor.localIdA03853-
dc.contributor.localIdA04696-
dc.contributor.localIdA04703-
dc.relation.journalcodeJ02214-
dc.identifier.eissn1536-5964-
dc.identifier.pmid26844509-
dc.contributor.alternativeNameKang, Sang Wook-
dc.contributor.alternativeNameKim, Min Jhi-
dc.contributor.alternativeNameKim, Tae Hyung-
dc.contributor.alternativeNameNam, Kee Hyun-
dc.contributor.alternativeNameBan, Eun Jeong-
dc.contributor.alternativeNameLee, Seul Gi-
dc.contributor.alternativeNameLee, Jan Dee-
dc.contributor.alternativeNameLee, Cho Rok-
dc.contributor.alternativeNameChung, Woung Youn-
dc.contributor.alternativeNameJeong, Jong Ju-
dc.contributor.alternativeNameJo, Young Suk-
dc.contributor.alternativeNameChoi, Jung Bum-
dc.contributor.alternativeNameHo, Joon-
dc.contributor.affiliatedAuthorKang, Sang Wook-
dc.contributor.affiliatedAuthorKim, Min Jhi-
dc.contributor.affiliatedAuthorKim, Tae Hyung-
dc.contributor.affiliatedAuthorNam, Kee Hyun-
dc.contributor.affiliatedAuthorBan, Eun Jeong-
dc.contributor.affiliatedAuthorLee, Seul Gi-
dc.contributor.affiliatedAuthorLee, Jan Dee-
dc.contributor.affiliatedAuthorLee, Cho Rok-
dc.contributor.affiliatedAuthorChung, Woung Youn-
dc.contributor.affiliatedAuthorJeong, Jong Ju-
dc.contributor.affiliatedAuthorJo, Young Suk-
dc.contributor.affiliatedAuthorChoi, Jung Bum-
dc.contributor.affiliatedAuthorHo, Joon-
dc.citation.volume95-
dc.citation.number5-
dc.citation.startPage2692-
dc.identifier.bibliographicCitationMEDICINE, Vol.95(5) : 2692, 2016-
dc.date.modified2017-02-24-
dc.identifier.rimsid53133-
dc.type.rimsART-
Appears in Collections:
1. College of Medicine (의과대학) > Dept. of Internal Medicine (내과학교실) > 1. Journal Papers
1. College of Medicine (의과대학) > Dept. of Surgery (외과학교실) > 1. Journal Papers

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