This scoping review, published in Expert Review of Anticancer Therapy, suggests that multiple lymph node characteristics increase papillary thyroid cancer (PTC) recurrence risk. The findings call into question whether current thresholds need to be lowered to adequately reflect the risk of recurrence.
Abstract
Introduction
Despite neck lymph node metastases occurring commonly in cases of PTC, there has remained controversy regarding the thresholds that should be used for lymph node characteristics in predicting PTC recurrence risk.
Areas covered
This scoping review explored the prognostic significance of lymph node characteristics in predicting risk of PTC recurrence. Following the PRISMA guidelines, the PubMed, Embase, and Web of Science databases were searched and supplemented by hand searching reference lists to identify articles published from database inception until October 2024. A total of 172 studies were included. Most studies had a retrospective cohort design and were reported from South Korea, Japan and China. In general, an increased number of metastatic lymph nodes (commonly > 5), presence of ENE, larger size of metastatic lymph nodes (commonly > 3 cm), higher LNR (commonly ≥0.3 or ≥0.4), and presence of lateral neck compartment nodal metastases were all associated with higher recurrence rates.
Expert Opinion
The lack of standardized definitions and terminology make the interpretation of findings difficult and limit generalizability. Future studies must focus on exploring long-term recurrence risk, in an exclusively PTC patient population, while also incorporating standardized definitions and terminology for lymph node characteristics and recurrence.