The Benefit of Primary Tumor Surgical Resection in Distant Metastatic Carcinomas of the Thyroid.
Adult
Aged
Aged, 80 and over
Carcinoma
/ diagnosis
Clinical Decision-Making
Female
Humans
Kaplan-Meier Estimate
Male
Middle Aged
Neoplasm Staging
Prognosis
Radiotherapy, Adjuvant
/ statistics & numerical data
Risk Assessment
/ statistics & numerical data
SEER Program
/ statistics & numerical data
Survival Rate
Thyroid Gland
/ pathology
Thyroid Neoplasms
/ diagnosis
Thyroidectomy
/ statistics & numerical data
Treatment Outcome
Young Adult
Thyroid cancer
clinical guidelines
evidence-based medicine
neck dissection
outcomes
Journal
The Laryngoscope
ISSN: 1531-4995
Titre abrégé: Laryngoscope
Pays: United States
ID NLM: 8607378
Informations de publication
Date de publication:
05 2021
05 2021
Historique:
revised:
02
07
2020
received:
20
05
2020
accepted:
06
08
2020
pubmed:
1
9
2020
medline:
8
5
2021
entrez:
1
9
2020
Statut:
ppublish
Résumé
Thyroid cancer with distant metastasis (TCDM) at diagnosis has significantly worse survival rates when compared to localized/regional thyroid cancer. This study sought to report on the characteristics of patients presenting with TCDM and the potential survival advantage of surgical resection. Data were acquired from the Surveillance, Epidemiology, and End Results (SEER) database with cases from 2004 to 2015. TCDM cases (n = 2,558) were identified from the SEER database. The Bonferroni correction was applied for multivariate analysis. Kaplan-Meier analysis was utilized to obtain disease-specific survival (DSS) rates. Cox regression analysis was utilized to identify independent factors significantly associated with survival. The average age of diagnosis of TCDM was 62.0 (±17.5) years. Patients were predominantly white (74.6%), female (54.6%), in a relationship (56.0%), and between ages 36 and 80 years (76.4%). Cases consisted of papillary (57.2%), follicular (16.0%), medullary (8.9%), anaplastic (17.9%) TCDM histological variants. Overall 1-, 5-, and 10-year DSS rates were 72.0%, 56.8%, and 43.8%, respectively. Anaplastic and medullary variants had the worst 10-year DSS (0% and 25.5%, respectively). Patients who underwent surgical resection only and surgical resection with radiation were 49% and 59% less likely to die, respectively. Treatment, age, histology, T staging, relationship status, and metastasis site were determined to be significant predictors of survival. Surgical resection with radiation was found to be a significant predictor of survival after applying the Bonferroni correction for all thyroid cancer variants except medullary. To increase survival, surgical intervention should be recommended in patients who are deemed to be medically tolerant of surgery. 4 Laryngoscope, 131:1026-1034, 2021.
Types de publication
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Pagination
1026-1034Informations de copyright
© 2020 American Laryngological, Rhinological and Otological Society Inc, "The Triological Society" and American Laryngological Association (ALA).
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