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Article: Does preoperative neutrophil lymphocyte ratio predict risk of recurrence and occult central nodal metastasis in papillary thyroid carcinoma?

TitleDoes preoperative neutrophil lymphocyte ratio predict risk of recurrence and occult central nodal metastasis in papillary thyroid carcinoma?
Authors
Issue Date2014
PublisherSpringer New York LLC. The Journal's web site is located at http://link.springer.de/link/service/journals/00268/
Citation
World Journal of Surgery, 2014, v. 38 n. 10, p. 2605-2612 How to Cite?
AbstractBackground Preoperative neutrophil to lymphocyte ratio (NLR) might be prognostic in papillary thyroid carcinoma (PTC). Given the controversy of prophylactic central neck dissection (pCND) in clinically nodal-negative (cN0) PTC, our study evaluated whether preoperative NLR predicted disease-free survival (DFS) and occult central nodal metastasis (CNM) in cN0 PTC. Methods A total of 191 patients who underwent pCND were analyzed. Complete blood counts with differential counts were taken before operation. NLR was calculated by dividing preoperative neutrophil count with lymphocyte count. Patients were categorized into NLR tertiles: first (NLR < 1.93; n = 63), second (NLR = 1.93-2.79; n = 64), and third tertile (NLR > 2.79; n = 64). Four other patient types, namely, benign nodular goiter, clinically nodal-positive (cN1) PTC, poorly differentiated thyroid carcinoma, and anaplastic thyroid carcinoma (ATC), were used as references. Results Age at operation (p < 0.001) and tumor size (p = 0.037) significantly increased with higher NLR. First tertile had significantly more TNM stage I tumors (p = 0.01) and lowest MACIS score (p = 0.002). Tumor size [hazard ratio (HR) 1.422, 95% confidence interval (CI) 1.119-1.809, p = 0.004] and multicentricity (HR = 2.545, 95% CI 1.073-6.024, p = 0.034) independently predicted DFS, whereas old age [odds ratio (OR) 1.026, 95% CI 1.006-1.046, p = 0.009), male (OR 2.882, 95% CI 1.348-6.172, p = 0.006), and large tumor (OR 1.567, 95% CI 1.209-2.032, p = 0.001) independently predicted occult CNM. NLR was not significantly associated with DFS or occult CNM. ATC had significantly higher NLR than cN1 PTC (7.28 vs. 2.74, p < 0.001). Conclusions Although a higher NLR may imply a poorer tumor profile, it was not significantly associated with a worse DFS or higher risk of occult CNM in cN0 PTC. Perhaps, future research should focus on the prognostic value in other thyroid cancer types with a poorer prognosis. © 2014 Société Internationale de Chirurgie.
Persistent Identifierhttp://hdl.handle.net/10722/197856
ISSN
2015 Impact Factor: 2.523
2015 SCImago Journal Rankings: 1.375

 

DC FieldValueLanguage
dc.contributor.authorLang, BHHen_US
dc.contributor.authorNg, CPCen_US
dc.contributor.authorAu, KBen_US
dc.contributor.authorWong, KPen_US
dc.contributor.authorWong, KKCen_US
dc.contributor.authorWan, KYen_US
dc.date.accessioned2014-06-02T15:17:35Z-
dc.date.available2014-06-02T15:17:35Z-
dc.date.issued2014en_US
dc.identifier.citationWorld Journal of Surgery, 2014, v. 38 n. 10, p. 2605-2612en_US
dc.identifier.issn0364-2313en_US
dc.identifier.urihttp://hdl.handle.net/10722/197856-
dc.description.abstractBackground Preoperative neutrophil to lymphocyte ratio (NLR) might be prognostic in papillary thyroid carcinoma (PTC). Given the controversy of prophylactic central neck dissection (pCND) in clinically nodal-negative (cN0) PTC, our study evaluated whether preoperative NLR predicted disease-free survival (DFS) and occult central nodal metastasis (CNM) in cN0 PTC. Methods A total of 191 patients who underwent pCND were analyzed. Complete blood counts with differential counts were taken before operation. NLR was calculated by dividing preoperative neutrophil count with lymphocyte count. Patients were categorized into NLR tertiles: first (NLR < 1.93; n = 63), second (NLR = 1.93-2.79; n = 64), and third tertile (NLR > 2.79; n = 64). Four other patient types, namely, benign nodular goiter, clinically nodal-positive (cN1) PTC, poorly differentiated thyroid carcinoma, and anaplastic thyroid carcinoma (ATC), were used as references. Results Age at operation (p < 0.001) and tumor size (p = 0.037) significantly increased with higher NLR. First tertile had significantly more TNM stage I tumors (p = 0.01) and lowest MACIS score (p = 0.002). Tumor size [hazard ratio (HR) 1.422, 95% confidence interval (CI) 1.119-1.809, p = 0.004] and multicentricity (HR = 2.545, 95% CI 1.073-6.024, p = 0.034) independently predicted DFS, whereas old age [odds ratio (OR) 1.026, 95% CI 1.006-1.046, p = 0.009), male (OR 2.882, 95% CI 1.348-6.172, p = 0.006), and large tumor (OR 1.567, 95% CI 1.209-2.032, p = 0.001) independently predicted occult CNM. NLR was not significantly associated with DFS or occult CNM. ATC had significantly higher NLR than cN1 PTC (7.28 vs. 2.74, p < 0.001). Conclusions Although a higher NLR may imply a poorer tumor profile, it was not significantly associated with a worse DFS or higher risk of occult CNM in cN0 PTC. Perhaps, future research should focus on the prognostic value in other thyroid cancer types with a poorer prognosis. © 2014 Société Internationale de Chirurgie.-
dc.languageengen_US
dc.publisherSpringer New York LLC. The Journal's web site is located at http://link.springer.de/link/service/journals/00268/en_US
dc.relation.ispartofWorld Journal of Surgeryen_US
dc.rightsThe original publication is available at www.springerlink.comen_US
dc.rightsCreative Commons: Attribution 3.0 Hong Kong License-
dc.titleDoes preoperative neutrophil lymphocyte ratio predict risk of recurrence and occult central nodal metastasis in papillary thyroid carcinoma?en_US
dc.typeArticleen_US
dc.identifier.emailLang, BHH: Blang@hku.hken_US
dc.identifier.authorityLang, BHH=rp01828en_US
dc.description.naturepostprint-
dc.identifier.doi10.1007/s00268-014-2630-z-
dc.identifier.pmid24809487-
dc.identifier.scopuseid_2-s2.0-84937108479-
dc.identifier.hkuros229091en_US
dc.identifier.volume38en_US
dc.identifier.issue10-
dc.identifier.spage2605-
dc.identifier.epage2612-
dc.publisher.placeUnited Statesen_US

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