Researchers reported that the log odds of positive lymph nodes (LODDS) carry prognostic value in patients with medullary thyroid carcinoma (MTC) and published their findings in Updates in Surgery.

Generally, MTC is treated with total thyroidectomy and varying degrees of lymph node dissection. MTC is more prone to lymph node metastasis than other forms of thyroid cancer, such as papillary thyroid carcinoma. 

“Currently, there is no consensus on the evaluation method of MTC lymph node metastasis,” the authors of the study wrote. So far, there have been a number of different methods proposed to conduct lymph node stagings, such as the number of positive lymph nodes (PLNNs), metastatic lymph node ratio, and LODDS. 


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Previous studies concluded that the LODDS was an independent prognostic indicator that performed better than the PLNNs. The authors of the study hence decided to further evaluate the usefulness of LODDS as a prognostic indicator in MTC. 

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By using the Surveillance, Epidemiology, and End Results database, the research team was able to obtain detailed information regarding the treatment course of patients with MTC and their LODDS. The study’s inclusion criteria included patients over 18 years of age who underwent total thyroidectomy.

In addition, the primary site had to be the thyroid gland, and the histological diagnosis must be medullary carcinoma. Patients who met any of the following criteria were excluded: unavailable lymph node status, follow-up time, or tumor stage or grade. 

“In the [competing risks model] after [restricted cubic splines], factors such as age over 55 years at diagnosis, being male, treatment with chemotherapy or radiotherapy, unknown tumor size, and LODDS >−1.004 were significantly associated with poor prognosis of patients both in univariate and multivariate analyses, while the presence of multifocal tumor indicated better prognosis,” the authors concluded. 

Reference

Cao ZX, Weng X, Huang JS, Long X. Prognostic value of LODDS in medullary thyroid carcinoma based on competing risk model and propensity score matching analysisUpdates Surg. Published online July 12, 2022. doi:10.1007/s13304-022-01320-7