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Minimal extrathyroidal extension does not affect survival of well-differentiated thyroid cancer

Minimal extrathyroidal extension does not affect survival of well-differentiated thyroid cancer Differentiated thyroid cancer (DTC) with minimal extrathyroidal extension (MEE) is classified as stage III regardless of thetumor size. In this study, we aim to examine the effect of MEE on the overall survival and management of this population.A retrospective cohort study was performed, which utilized the National Cancer Database (NCDB), 2004–2012. The study populationincluded patients, aged ≥ 45 years, who underwent surgery for DTC (pT3N0M0) with MEE compared to that in patients with pT2N0M0.A total of 9556 patients were included. These were divided into four groups, 4410 patients with pT2N0M0 (Group 1: T ≤ 4 cmwithout MEE), 3274 with pT3N0M0 (Group 2: T ≤ 4 cm with MEE), 447 with pT3N0M0 (Group 3: T > 4 cm with MEE) and 1430 patientswith pT3N0M0 without MEE (Group 4: T > 4 cm without MEE). Median follow-up time was 46.7 months (interquartile range: 27.8–72.1).Patients in Group 2 (T ≤ 4 cm with MEE) had no significant worse survival compared to patients in Group 1 (T ≤ 4 cm withoutMEE) (P = 0.85), whereas Groups 3 and 4 (T > 4 cm), both had significantly lower survival (P < 0.001) with no difference between the two groups. Total thyroidectomy was associated with improved overall survival comparedto that in lobectomy in Group 4 (T > 4 cm without MEE). Radioiodine utilization was associated with improved survival onlywith tumors larger than 4 cm with or without MEE. In DTC patients aged older than 45 years of age with tumor size less than4 cm, MEE has no survival significance. Tumor size is an independent prognostic marker regardless of MEE status. Our datasupport re-evaluation of the current staging system. http://www.deepdyve.com/assets/images/DeepDyve-Logo-lg.png Endocrine Related Cancer Bioscientifica

Minimal extrathyroidal extension does not affect survival of well-differentiated thyroid cancer

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Publisher
Bioscientifica
Copyright
© 2017 Society for Endocrinology
ISSN
1351-0088
eISSN
1479-6821
DOI
10.1530/ERC-16-0509
pmid
28249964
Publisher site
See Article on Publisher Site

Abstract

Differentiated thyroid cancer (DTC) with minimal extrathyroidal extension (MEE) is classified as stage III regardless of thetumor size. In this study, we aim to examine the effect of MEE on the overall survival and management of this population.A retrospective cohort study was performed, which utilized the National Cancer Database (NCDB), 2004–2012. The study populationincluded patients, aged ≥ 45 years, who underwent surgery for DTC (pT3N0M0) with MEE compared to that in patients with pT2N0M0.A total of 9556 patients were included. These were divided into four groups, 4410 patients with pT2N0M0 (Group 1: T ≤ 4 cmwithout MEE), 3274 with pT3N0M0 (Group 2: T ≤ 4 cm with MEE), 447 with pT3N0M0 (Group 3: T > 4 cm with MEE) and 1430 patientswith pT3N0M0 without MEE (Group 4: T > 4 cm without MEE). Median follow-up time was 46.7 months (interquartile range: 27.8–72.1).Patients in Group 2 (T ≤ 4 cm with MEE) had no significant worse survival compared to patients in Group 1 (T ≤ 4 cm withoutMEE) (P = 0.85), whereas Groups 3 and 4 (T > 4 cm), both had significantly lower survival (P < 0.001) with no difference between the two groups. Total thyroidectomy was associated with improved overall survival comparedto that in lobectomy in Group 4 (T > 4 cm without MEE). Radioiodine utilization was associated with improved survival onlywith tumors larger than 4 cm with or without MEE. In DTC patients aged older than 45 years of age with tumor size less than4 cm, MEE has no survival significance. Tumor size is an independent prognostic marker regardless of MEE status. Our datasupport re-evaluation of the current staging system.

Journal

Endocrine Related Cancer – Bioscientifica

Published: May 1, 2017

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