Central lymph node ratio threshold predicts lateral lymph node metastasis in pediatric differentiated thyroid carcinoma

This retrospective cohort study included pediatric patients with differentiated thyroid carcinoma aged ≤14 years. Participants underwent thyroid lobectomy and therapeutic central neck dissection with concurrent or staged lateral neck dissection from 2015 to 2025. The setting involved patients receiving these specific surgical procedures during the specified timeframe.

The exposure assessed was the central lymph node ratio (LNR) compared against lateral lymph node metastasis (LLNM) status. The primary outcome focused on predicting LLNM based on central LNR thresholds. Comparisons were made using LLNM status as a grouping comparator for analysis.

A central LNR threshold of 0.4 predicted LLNM with a sensitivity of 90.0% and specificity of 76.0%. The odds ratio was 11.374. Multivariate analysis identified central LNR (OR = 3.741), bilaterality (OR = 3.850), and ≥4 metastatic central nodes (OR = 4.732) as independent predictors.

Safety data regarding adverse events were not reported in the provided text. Serious adverse events and discontinuations were also not reported. Tolerability information was not reported. Limitations were not explicitly listed in the source material. Practice relevance suggests an LNR ≥0.4 serves as a key indicator for identifying high-risk pediatric DTC patients for surgical consideration.