Optimal value of lymph node ratio and metastatic lymph node size to predict risk of recurrence in pediatric thyroid cancer with lateral neck metastasis

The probability of lymph node metastasis in children, approximately 50-90%, is higher than that of adult thyroid cancer [1–5]. Previous adult studies have reported that cervical lymph node metastasis is a well-known risk factor for recurrence [6–8]. Likewise, cervical lymph node metastasis is a significant factor for persistent/recurrent disease in pediatric thyroid cancer [9]. Nodal staging in thyroid cancer is very important because it not only stratifies patients in order to set a proper treatment plan, but also helps to predict disease prognosis.