Department of Visceral, Vascular and Endocrine Surgery, Martin Luther University Halle-Wittenberg, Halle (Saale), Germany.
Department of General, Visceral and Transplantation Surgery, Section of Endocrine Surgery, University of Duisburg-Essen, Essen, Germany.
Head Neck. 2022 Dec;44(12):2717-2726. doi: 10.1002/hed.27181. Epub 2022 Sep 6.
In medullary thyroid cancer (MTC), it is unclear which nodal classification system, metastatic lymph node ratio (MLNR), number of node metastases, or TNM/AJCC N classification, predicts cancer-specific survival best.
Kaplan-Maier analysis of cancer-specific survival after operation at a tertiary center.
Included were 505 MTC patients. The spread of the survival curves was greatest after stratification by MLNR (in 0.20 increments), followed by number of node metastases (in 10-node and 20-node increments) and TNM/AJCC classification (N0, N1a, N1b). After collapsing overlapping survival curves, all adjacent curves (MLNRs ≤0.20 vs. 0.21-0.60 vs. >0.60; 0 vs. 1-20 vs. >20 node metastases; and TNM/AJCC N classification N0/N1a vs. N1b) significantly differed between each other.
In MTC, MLNR, reflecting intensity of lymphatic spread, predicts cancer-specific survival better than number of node metastases or TNM/AJCC N classification. The applicability of these findings to patients with limited neck dissection requires more research.
在甲状腺髓样癌（MTC）中，尚不清楚哪种淋巴结分类系统、转移淋巴结比例（MLNR）、淋巴结转移数量或 TNM/AJCC N 分类能更好地预测癌症特异性生存。
在三级中心进行手术治疗后，采用 Kaplan-Meier 分析癌症特异性生存。
共纳入 505 例 MTC 患者。在按 MLNR（每 0.20 个增量）、淋巴结转移数量（每 10 个和 20 个增量）和 TNM/AJCC 分类（N0、N1a、N1b）分层后，生存曲线的扩散程度最大。在合并重叠生存曲线后，所有相邻曲线（MLNRs ≤0.20 比 0.21-0.60 比 >0.60；0 比 1-20 比 >20 个淋巴结转移；以及 TNM/AJCC N 分类 N0/N1a 比 N1b）之间存在显著差异。
在 MTC 中，反映淋巴扩散强度的 MLNR 比淋巴结转移数量或 TNM/AJCC N 分类更能预测癌症特异性生存。这些发现对接受有限颈部清扫术的患者的适用性需要进一步研究。
