scholarly journals Synergic effects of histology subtype, tumor size, and lymph node metastasis on distant metastasis in differentiated thyroid cancer

2019 ◽  
Vol 7 (20) ◽  
pp. 533-533 ◽  
Author(s):  
Zeming Liu ◽  
Sichao Chen ◽  
Yihui Huang ◽  
Di Hu ◽  
Wen Zeng ◽  
...  
2005 ◽  
Vol 71 (9) ◽  
pp. 731-734 ◽  
Author(s):  
Yale D. Podnos ◽  
David Smith ◽  
Lawrence D. Wagman ◽  
Joshua D.I. Ellenhorn

Though survival for well-differentiated thyroid cancer is very good, specific populations suffer greater recurrence and mortality. Defining these cohorts can significantly influence prognosis and extent of treatment. This study, using a large, multi-institutional database, seeks to determine how the presence of lymph node disease in patients with well-differentiated thyroid cancer affects outcome. The Surveillance, Epidemiology, and End Results (SEER) database is a large-scale sample of 14 per cent of the U.S. population. It was used to identify patients with papillary and follicular thyroid carcinomas and identify the prognostic implications of lymph node metastasis. Additional factors, including presence of metastasis, age, and tumor size, were compared using multivariate and χ2 analyses. Of 19,918 patients identified, lymph node status was known for 9,904 (49.7%). On multivariate analysis, age >45 years, presence of distant metastasis, large tumor size, and lymph node involvement significantly predicted poor outcome. Overall survival at 14 years was 82 per cent for node negative and 79 per cent for node positive patients ( P < 0.05). This study shows that the survival of patients with well-differentiated thyroid cancer is adversely affected by lymph node metastases. The optimum treatment for this cohort needs further delineation, as particular populations are at greater risk of recurrence and death.


2021 ◽  
Author(s):  
Cinthia Minatel Riguetto ◽  
Icléia Siqueira Barreto ◽  
Frederico Fernandes Ribeiro Maia ◽  
Ligia Vera Montali da Assumpção ◽  
Denise Engelbrecht Zantut-Wittmann

Abstract Purpose This study aims to show the relationship between neutrophil-lymphocyte ratio (NLR), platelet-lymphocyte ratio (PLR) and monocyte-lymphocyte ratio (MLR), with clinicopathological characteristics in patients with differentiated thyroid cancer (DTC). Methods This is a retrospective study involving 390 DTC patients who had complete blood cell count available at the time of the surgery. NLR, PLR, and MLR were calculated, risk of cancer-related death, structural recurrence, and response to therapy were assessed by the 8th edition of the tumor-node-metastasis (TNM), American Thyroid Association (ATA) Risk Stratification System, and ATA Response to Therapy Reclassification, respectively. Results PLR was higher in distant metastasis (133.15±43.95 vs 119.24±45.69, p = 0.0345), lower in disease-free versus persistent disease or death (117.72±44.70 vs 131.07±47.85, p = 0.0089). In MLR, patients ≥55 had a higher score than < 55 years old (0.26±0.10 vs 0.24±0.12, p = 0.0379). Higher MLR (OR 8.775; 95% CI = 1.532–50.273; p = 0.0147), intermediate (OR 4.892; 95% CI = 2.492–9.605; p ≤ 0.0001) and high ATA risks (OR 5.998; 95% CI = 3.126–11.505; p ≤ 0.0001) were risk factors associated with active disease. NLR was not significant. ROC curve cut-off values for NLR, PLR, and MLR were able to discriminate distant from lymph node metastasis (NLR > 1.93 sensitivity 73.3%, specificity 58.7%; PLR > 124.34 sensitivity 86.7%, specificity 69.2%; MLR > 0.21 sensitivity 80%, specificity 45.2%). Conclusion Cut-off values of NLR, PLR, and MLR discriminated the presence of distant metastasis from lymph node metastasis with good sensitivity and accuracy. PLR was an associated factor with disease-free status and higher in DTC patients with distant metastasis, persistency, and disease-related death. MLR was a risk factor of active disease.


2021 ◽  
pp. 1-8
Author(s):  
Yuwei Liu ◽  
Shengcai Wang ◽  
Yanzhen Li ◽  
Xuexi Zhang ◽  
Zhiyong Liu ◽  
...  

<b><i>Objectives:</i></b> The objectives of this study were to explore the clinical heterogeneity of differentiated thyroid cancer (DTC) between prepubertal children and adolescents and guide clinical treatment. <b><i>Methods:</i></b> A retrospective study included patients with DTC aged ≤19 years in Beijing Children’s Hospital from June 2014 to June 2019. All patients were enrolled and divided into 2 subgroups based on the threshold age of 10 years, namely the childhood group (CG) (≤10 years old); and the adolescent group (AG) (between 10 and 19 years old). The χ<sup>2</sup> test and Fisher’s exact test were used to estimate the effect of risk factors in the 2 age groups. Multivariate binary logistic regression models were conducted to assess the recurrent risk factors. <b><i>Results:</i></b> Seventy cases of DTC were included with an average age of 9.94 ± 2.88 years, including 35 in CG and 35 in AG. The most common clinical manifestation was a painless mass in the neck, accounting for 77.1% (54/70) of patients. Compared with the AG, the CG was more likely to have lymph node metastasis (<i>p</i> = 0.022) and distant metastasis (<i>p</i> = 0.041). The CG was more likely to have extrathyroidal extension (<i>p</i> = 0.012) and had a significantly higher recurrence rate than the AG (<i>p</i> = 0.040). Age was an independent variable predictive of recurrence (<i>p</i> = 0.0347). <b><i>Conclusion:</i></b> Regional invasiveness, cervical lymph node metastasis, and distant metastasis of DTC were more likely to occur in children ≤10 years old. Meanwhile, children ≤10 years old with DTC were more likely to have recurrence than adolescent’s postsurgical treatment. Thus, children younger than 10 years of age with DTC should be treated more aggressively.


2017 ◽  
Vol 13 (6) ◽  
pp. 4327-4333 ◽  
Author(s):  
Tomonari Cho ◽  
Eisuke Shiozawa ◽  
Fumihiko Urushibara ◽  
Nana Arai ◽  
Toshitaka Funaki ◽  
...  

2021 ◽  
Vol 11 ◽  
Author(s):  
Yiming Qi ◽  
Shuangshuang Wu ◽  
Linghui Tao ◽  
Yunfu Shi ◽  
Wenjuan Yang ◽  
...  

BackgroundFor different lymph node metastasis (LNM) and distant metastasis (DM), the diagnosis, treatment and prognosis of T1-2 non-small cell lung cancer (NSCLC) are different. It is essential to figure out the risk factors and establish prediction models related to LNM and DM.MethodsBased on the surveillance, epidemiology, and end results (SEER) database from 1973 to 2015, a total of 43,156 eligible T1-2 NSCLC patients were enrolled in the retrospective study. Logistic regression analysis was used to determine the risk factors of LNM and DM. Risk factors were applied to construct the nomograms of LNM and DM. The predictive nomograms were discriminated against and evaluated by Concordance index (C-index) and calibration plots, respectively. Decision curve analysis (DCAs) was accepted to measure the clinical application of the nomogram. Cumulative incidence function (CIF) was performed further to detect the prognostic role of LNM and DM in NSCLC-specific death (NCSD).ResultsEight factors (age at diagnosis, race, sex, histology, T-stage, marital status, tumor size, and grade) were significant in predicting LNM and nine factors (race, sex, histology, T-stage, N-stage, marital status, tumor size, grade, and laterality) were important in predicting DM(all, P&lt; 0.05). The calibration curves displayed that the prediction nomograms were effective and discriminative, of which the C-index were 0.723 and 0.808. The DCAs and clinical impact curves exhibited that the prediction nomograms were clinically effective.ConclusionsThe newly constructed nomograms can objectively and accurately predict LNM and DM in patients suffering from T1-2 NSCLC, which may help clinicians make individual clinical decisions before clinical management.


2021 ◽  
Author(s):  
Jingjing Gu ◽  
Dandan Chen ◽  
Zhiqiang li ◽  
Yongliang Yang ◽  
Zhaoming Ma ◽  
...  

Abstract Purpose: This meta-analysis investigated the relationships between the CD44+/CD24- phenotype and tumor size, lymph node metastasis, distant metastasis, disease-free survival (DFS), and overall survival (OS) in 8036 postoperative breast cancer patients enrolled in 23 studies.Methods: A literature search of PubMed, Medline, Cochrane, Embase, and PMC was conducted to identify eligible studies. The combined odds ratios (ORs) and 95% confidence intervals (95%CIs) were analyzed to evaluate the relationships between the CD44+/CD24- phenotype and the pathological and biological characteristics of breast cancer patients, and the combined hazard ratios (HRs) and 95% CIs were calculated to evaluate the relationships between CD44+/CD24- and DFS and OS of breast cancer petients using Stata12.0 software.Results: The CD44+/CD24- phenotype were not related to the tumor size (tumor size > 2.0 cm vs ≤ 2.0 cm, combined OR = 0.98, 95%CI: 0.68–1.34, p = 0.792) and didn’t promote lymph node metastasis (lymph node metastasis vs. no lymph node metastasis, combined OR = 0.94, 95% CI: 0.71–1.26, p = 0.692) and distant metastasis (distant metastasis vs no distant metastasis, combined OR = 3.88, 95% CI: 0.93–16.24, p = 0.064). The CD44+/CD24- phenotype was negatively correlated with postoperative DFS (HR = 1.67, 95% CI: 1.35–2.07, p <0.00001) and OS (combined HR = 1.52, 95%CI: 1.21–1.91, p = 0.0004).Conclusion: These results suggested expression of the CD44+/CD24- phenotype can be used as a reliable indicator of clinical prognosis and a potential therapeutic targets in breastcancer patients.


2021 ◽  
Vol 12 ◽  
Author(s):  
Xingchen Li ◽  
Yuansheng Duan ◽  
Dandan Liu ◽  
Hongwei Liu ◽  
Mengqian Zhou ◽  
...  

The Delphian lymph node (DLN), also known as the prelaryngeal node, is one component of the central lymph node. The DLN has been well studied in laryngeal cancer, although its significance in papillary thyroid cancer (PTC) remains unclear. We retrospectively analyzed 936 patients with PTC who underwent thyroidectomy by a single surgeon in Tianjin Cancer Hospital from 2017 to 2019. Moreover, 250 PTC patients who underwent thyroidectomy by another surgeon in Tianjin Cancer Hospital from January 2019 to April 2019 were used as a validation cohort. Among the 936 patients with PTC, 581 patients (62.1%) had DLNs, of which 177 samples with metastasis (177/581, 30.5%) were verified. DLN metastasis was significantly correlated with sex, age, tumor size, bilateral cancer, multifocality, extrathyroidal extension, lymphovascular invasion and central and lateral neck lymph node metastasis. Multivariate analysis revealed that independent risk factors for DLN metastasis included age, gender, tumor size, extrathyroid extension, lymphovascular invasion and central lymph node metastasis, which determined the nomogram. In particular, tumor size was proven to be one of the most predominant single predictors. The diagnostic model had an area under the curve (AUC) of 0.829 (95% confidence interval, 0.804–0.854). The internal and external validations of the nomogram were 0.819 and 0.745, respectively. Our results demonstrate that DLN metastasis appears to be a critical parameter for predicting metastatic disease of the central compartments. Furthermore, this study provides a precise criterion for assessing DLN metastasis and has great clinical significance for treating PTC.


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