Male patients have a significantly higher prevalence of advanced-stage thyroid cancer. However, sex differences in the risk of differentiated thyroid carcinoma (DTC) recurrence have not been fully elucidated. Therefore, the present study aimed to investigate male sex as a prognostic factor for DTC. We assessed 5566 patients with DTC who underwent thyroid surgery between January 2009 and December 2015 at Seoul St. Mary’s Hospital (Seoul, Korea). Clinicopathological characteristics and long-term oncologic outcomes between female and male patients with DTC were compared using propensity score matching to reduce selection bias. The mean follow-up duration was 99.9 ± 18.7 months. The recurrence rate was significantly higher in male patients than female patients before matching (3.3% vs. 2.2%, p = 0.030), and there was no significant difference in recurrence rates between the matched groups after matching (3.0% vs. 2.5%, p = 0.591). Based on Kaplan–Meier analysis, the two groups did not significantly differ in disease-free survival after matching. Multivariate analysis revealed that male sex was not an independent prognostic factor of DTC recurrence. Male sex did not have a significant effect on DTC recurrence. Further studies with larger cohorts are required to validate the findings of this study.

Purpose To date, no studies have been performed on staging based on the lymph node ratio (LNR) in elderly patients with gastric cancer who may require limited lymph node (LN) dissection due to morbidity and tissue fragility. We aimed to develop a new N staging system using the LNR in elderly patients with gastric cancer. Materials and Methods The present study included patients aged over 75 years who underwent curative gastrectomy between January 1989 and December 2018. Clinicopathological data including the number of retrieved and metastatic LNs were collected and the LNR values were obtained (LNR = the number of metastatic LNs/the number of retrieved LNs). Eleven LNR groups with intervals of 0.1 were divided into four stages based on the inflection points at which the hazard ratio (HR) increased. Survival analysis was performed to evaluate the prognostic value of the LNR. Results The four LNR stages included LNR0 (n=364), LNR1 (n=128), LNR2 (n=103), and LNR3 (n=10). In the multivariate analysis, both N staging and LNR staging exhibited significant prognostic values for predicting survival outcomes. However, the incremental change in the hazard ratio (HR) between consecutive stages was greater for the LNR staging than for the N staging (HRs: 1.607, 2.758, and 3.675 for N staging; 1.583, 3.514, and 10.261 for LNR staging). Conclusions LNR staging is more useful than N staging in predicting the prognosis in elderly patients with gastric cancer and may be used as a complement or alternative to N staging.

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The purpose of this study was to establish the risk factors for re-recurrences and disease-specific mortality (DSM) in recurrent thyroid cancer. Patients with recurrent thyroid cancer who underwent initial thyroid surgery from January 2000 to December 2019 at Seoul St. Mary’s Hospital (Seoul, Korea) were assessed. Clinicopathological characteristics and long-term oncologic outcomes were compared between patients with one recurrence (n = 202) and patients with re-recurrences (n = 44). Logistic regression and cox-regression analyses were conducted to determine the risk factors for re-recurrences and DSM, respectively. Receiver-operating characteristic curve analysis was performed to determine the cutoff value for lymph node ratio (LNR) as a predictor of re-recurrences. DSM was significantly higher in the re-recurrence group compared with the single-recurrence group (6.8% vs. 0.5%, p = 0.019). Surgical treatment at the first recurrence significantly lowered the risk of re-recurrences. Age (≥55), male sex, and LNR (≥0.15) were independent significant risk factors for re-recurrences in patients who underwent surgery at the first recurrence. Surgical resection is the optimal treatment for initial thyroid cancer recurrence. LNR at re-operation is more effective in predicting re-recurrence than the absolute number of metastatic LNs.