Secular trends in the prognostic factors for papillary thyroid cancer

ObjectiveWith the recent increasing rates of screening for thyroid cancer, the cancers now tend to be smaller and less aggressive than those that are diagnosed when presented with symptoms, suggesting changes in the clinical validity of conventional prognostic factors for outcomes. We performed the retrospective study to identify the secular trends in the prognostic factors of thyroid cancer.MethodsWe used medical records of 3147 patients diagnosed with papillary thyroid cancer (PTC) at the Seoul National University Hospital Thyroid Cancer Clinic between 1962 and 2009.ResultsDuring the median 5.1-year follow-up, the overall recurrence rate was 13.3%, and male sex, tumor size, lymph node (LN) involvement, and extrathyroidal extension (ETE) were the significant prognostic factors for recurrence. Thyroid cancer-specific mortality was 1.4%, and the associated prognostic factors were older age, male sex, and LN involvement. For tumor recurrence, the hazard ratio (HR) for male sex decreased from 2.809 (95% CI, 1.497–5.269) in the pre-1989 period to 1.142 (95% CI, 0.736–1.772) in the post-1999 period. The pathologic characteristics, such as tumor size, LN involvement, and ETE, showed similar or increasing HRs over the time periods. For cancer-specific mortality, the HR for male sex decreased from 6.460 (95% CI, 1.714–24.348) in the pre-1990 period to 0.781 (95% CI, 0.083–7.379) in the post-1999 period.ConclusionThe risk for poor outcomes in PTC associated with male sex decreased over time; in contrast, the risk associated with pathologic characteristics remained the same or increased over time. These trends might be associated with recent changes in the characteristics of patients with thyroid cancer.

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BRAF V600E Confers Male Sex Disease-Specific Mortality Risk in Patients With Papillary Thyroid Cancer

Journal of Clinical Oncology ◽

10.1200/jco.2018.78.5097 ◽

2018 ◽

Vol 36 (27) ◽

pp. 2787-2795 ◽

Cited By ~ 17

Author(s):

Fei Wang ◽

Shihua Zhao ◽

Xiaopei Shen ◽

Guangwu Zhu ◽

Rengyun Liu ◽

...

Keyword(s):

Thyroid Cancer ◽

Papillary Thyroid Cancer ◽

Mortality Rates ◽

Interquartile Range ◽

Braf V600e ◽

Papillary Thyroid ◽

Wild Type ◽

Specific Mortality ◽

Male Sex ◽

Multivariable Adjustment

Purpose To test whether the prognostic risk of male sex in papillary thyroid cancer (PTC) is determined by BRAF V600E and can thus be stratified by BRAF status. Patients and Methods We retrospectively investigated the relationship between male sex and clinicopathologic outcomes in PTC, particularly mortality, with respect to BRAF status in 2,638 patients (male, n = 623; female, n = 2,015) from 11 centers in six countries, with median age of 46 years (interquartile range, 35-58 years) at diagnosis and median follow-up time of 58 months (interquartile range, 26-107 months). Results Distant metastasis rates in men and women were not different in wild-type BRAF PTC but were different in BRAF V600E PTC: 8.9% (24 of 270) and 3.7% (30 of 817; P = .001), respectively. In wild-type BRAF PTC, mortality rates were 1.4% (five of 349) versus 0.9% (11 of 1175) in men versus women ( P = .384), with a hazard ratio (HR) of 1.59 (95% CI, 0.55 to 4.57), which remained insignificant at 0.70 (95% CI, 0.23 to 2.09) after clinicopathologic multivariable adjustment. In BRAF V600E PTC, mortality rates were 6.6% (18 of 272) versus 2.9% (24 of 822) in men versus women ( P = .006), with an HR of 2.43 (95% CI, 1.30 to 4.53), which remained significant at 2.74 (95% CI, 1.38 to 5.43) after multivariable adjustment. In conventional-variant PTC, male sex similarly had no effect in wild-type BRAF patients; mortality rates in BRAF V600E patients were 7.2% (16 of 221) versus 2.9% (19 of 662) in men versus women ( P = .004), with an HR of 2.86 (95% CI, 1.45 to 5.67), which remained significant at 3.51 (95% CI, 1.62 to 7.63) after multivariable adjustment. Conclusion Male sex is a robust independent risk factor for PTC-specific mortality in BRAF V600E patients but not in wild-type BRAF patients. The prognostic risk of male sex in PTC can thus be stratified by BRAF status in clinical application.

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Decreasing tumor size of thyroid cancer in Germany: institutional experience 1995–2009

Acta Endocrinologica ◽

10.1530/eje-10-0203 ◽

2010 ◽

Vol 163 (1) ◽

pp. 111-119 ◽

Cited By ~ 14

Author(s):

Andreas Machens ◽

Henning Dralle

Keyword(s):

Thyroid Cancer ◽

Papillary Thyroid Cancer ◽

Tumor Size ◽

Medullary Thyroid Cancer ◽

Secular Trends ◽

Papillary Thyroid ◽

Follicular Thyroid Cancer ◽

Thyroid Cancers ◽

Medullary Thyroid ◽

Screening Programs

ObjectiveDecreasing tumor size in a population over time is widely interpreted as a measure of effectiveness of cancer screening programs. Nonetheless, thyroid cancer size is rarely analyzed as a function of time. This study aimed to explore secular trends of thyroid cancer diameter in Germany.DesignRetrospective analysis of 1644 thyroid cancer patients from a large referral center for thyroid cancer (1995–2009).MethodsCalculation of largest tumor diameters for each type of cancer as a function of time periods and birth cohorts.ResultsOver the past 25 years, subdivided into 5-year periods by year of thyroidectomy (1985–1989; 1990–1994; 1995–1999; 2000–2004; 2005–2009), tumor diameters diminished from 25 to 16 mm (P=0.025) for medullary thyroid cancer and from 28 to 18 mm (P=0.017) for papillary thyroid cancer. This reduction was greater for hereditary medullary thyroid cancer (from 27 to 11 mm; P=0.088) than sporadic medullary thyroid cancer (from 23 to 19 mm; P=0.11). No decline was observed for follicular thyroid cancer (means of 45 to 42 mm; P=0.52). From the first (1921–1940) to the most recent birth cohort (1981–2000), tumor size fell from 22 to 10 mm (P<0.001) for medullary thyroid cancer, from 24 to 22 mm (P<0.001) for papillary thyroid cancer, and from 49 to 38 mm (P=0.011) for follicular thyroid cancer. The reduction of medullary thyroid cancers affected exclusively patients with hereditary disease (from 20 to 7 mm; P<0.001).ConclusionThe consistency and robustness of these data signify powerful secular trends toward smaller papillary, follicular, and medullary thyroid cancers. The causes and consequences of these trends warrant further investigation.

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Male Patients With Papillary Thyroid Cancer Have a Higher Risk of Extranodal Extension

10.21203/rs.3.rs-542939/v1 ◽

2021 ◽

Author(s):

Hu Hei ◽

Bin Zhou ◽

Wenbo Gong ◽

Chen Zheng ◽

Jianwu Qin

Keyword(s):

Thyroid Cancer ◽

Papillary Thyroid Cancer ◽

Multivariable Analysis ◽

Underlying Mechanism ◽

Clinicopathological Factors ◽

Papillary Thyroid ◽

Extranodal Extension ◽

Increased Risk ◽

Male Patients ◽

Male Sex

Abstract Purpose: There is a sex disparity in papillary thyroid cancer (PTC). Male sex is associated with a higher likelihood of advanced stage disease. This study aimed to examine the significance of sex for extranodal extension (ENE) in PTC. Patients and Methods: We reviewed the data of PTC patients who had undergone initial surgical resection from July 2012 to December 2014 (N = 1531). The effects of sex and other clinicopathological factors on ENE were investigated.Results: Of 1531 patients identified, 377 (24.6%) were male, 816 (53.3%) had positive nodes, and 256 (16.7%) had ENE. Compared with female patients, male patients had a higher risk of ENE (P < 0.001). Multivariable analysis of clinicopathological factors revealed that male sex (odds ratio [OR], 1.98; 95% confidence interval [CI], 1.37 - 2.87; P < 0.001), age older than 60 years (OR, 1.93; 95% CI, 1.08 - 3.35; P = 0.023), extrathyroidal extension (OR, 3.52; 95% CI, 2.42 - 5.14; P < 0.001), bilateral multifocality (OR, 2.18; 95% CI, 1.53 - 3.13; P < 0.001), and more positive nodes were significantly associated with increased risk of ENE. Patients with 6-10 positive nodes were 16.45-fold higher to have ENE than patients with 5 positive nodes or less (95% CI, 11.07 - 24.68; P < 0.001).Conclusion: Male PTC patients had a higher risk of ENE than female. Sex was an independent predictor of ENE. The underlying mechanism needs to be investigated further.

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Association of tumor size and focality with recurrence/persistence in papillary thyroid cancer patients treated with total thyroidectomy along with radioactive-iodine ablation and TSH suppression

Updates in Surgery ◽

10.1007/s13304-017-0465-5 ◽

2017 ◽

Vol 70 (1) ◽

pp. 121-127 ◽

Cited By ~ 1

Author(s):

Misbah Khan ◽

Aamir Ali Syed ◽

Amina Iqbal Khan ◽

Syed Raza Hussain ◽

Namra Urooj

Keyword(s):

Thyroid Cancer ◽

Total Thyroidectomy ◽

Cancer Patients ◽

Papillary Thyroid Cancer ◽

Tumor Size ◽

Radioactive Iodine ◽

Papillary Thyroid ◽

Tsh Suppression ◽

Radioactive Iodine Ablation

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The Risk of Relapse in Papillary Thyroid Cancer (PTC) in the Context of BRAFV600E Mutation Status and Other Prognostic Factors

PLoS ONE ◽

10.1371/journal.pone.0132821 ◽

2015 ◽

Vol 10 (7) ◽

pp. e0132821 ◽

Cited By ~ 19

Author(s):

Agnieszka Czarniecka ◽

Monika Kowal ◽

Dagmara Rusinek ◽

Jolanta Krajewska ◽

Michal Jarzab ◽

...

Keyword(s):

Thyroid Cancer ◽

Prognostic Factors ◽

Papillary Thyroid Cancer ◽

Papillary Thyroid ◽

Brafv600e Mutation ◽

Mutation Status ◽

Risk Of Relapse

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Correlation between F18-FDG PET/CT Imaging and BRAF V600E Genetic Mutation for the Early Assessment of Treatment Response in Papillary Thyroid Cancers

Journal of Personalized Medicine ◽

10.3390/jpm10020052 ◽

2020 ◽

Vol 10 (2) ◽

pp. 52

Author(s):

Andra Piciu ◽

Maria-Iulia Larg ◽

Doina Piciu

Keyword(s):

Thyroid Cancer ◽

Prognostic Factors ◽

Papillary Thyroid Cancer ◽

Genetic Mutation ◽

Braf V600e Mutation ◽

Braf V600e ◽

Papillary Thyroid ◽

Early Assessment ◽

Pet Ct ◽

Ct Evaluation

In thyroid neoplastic pathology, the BRAF V600E mutation is shown to be involved in the oncogenesis of papillary thyroid cancer and its subtypes. The purpose of this study is to evaluate the correlation between the mutation of the BRAF V600E oncogene and the pathological standardized uptake values (SUV) at the F18-fluorodeoxyglucose (F18-FDG) positron emission tomography/computed tomography (PET/CT) evaluation, for a group of 20 patients with radically treated (total thyroidectomy and radioiodine therapy) papillary thyroid cancer, with subclinical persistent disease, at 6 months after the initial treatment. We analyzed the correlations between the values of SUV and the presence of the BRAF mutation as well with other prognostic factors such as stage, age, specific tumor markers (thyroglobulin and anti-thyroglobulin), extrathyroid extension, the presence of metastatic lymph nodes or distant metastasis. The value of SUV in the case of BRAF+ (positive) patients was higher than in the negative ones, but without statistical significance, thus, the values of the SUV cannot be a predictable factor for the presence of the genetic mutation. There was a statistically significant correlation in BRAF+ subgroup between the SUV values and the positive resection limit following surgery, showing a higher SUV value in the PET/CT evaluation. No correlation was observed between the aforementioned prognostic factors involved in papillary thyroid cancer and the BRAF V600E mutation.

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