scholarly journals High Incidence of Distant Metastasis Is Associated With Histopathological Subtype of Pediatric Papillary Thyroid Cancer - a Retrospective Analysis Based on SEER

2021 ◽  
Vol 12 ◽  
Author(s):  
Xue Zeng ◽  
Zhihong Wang ◽  
Zhiqiang Gui ◽  
Jingzhe Xiang ◽  
Mengsu Cao ◽  
...  
Keyword(s):  
Risk Factors ◽  
Thyroid Cancer ◽  
Young Children ◽  
Distant Metastasis ◽  
Regression Models ◽  
Extrathyroidal Extension ◽  
Papillary Thyroid ◽  
Logistic Regression Models ◽  
Node Metastasis ◽  
Histopathological Subtype

ObjectiveChildren with papillary thyroid cancer (PTC) have a higher invasive rate and distant metastasis rate, but the mortality rate is lower with unknown reasons. The majority of PTC cases comprise classical papillary thyroid carcinoma (CPTC) and follicular variant papillary thyroid carcinoma (FVPTC). This study aimed to determine the relationship between histopathological subtype and rate of distant metastasis and investigate factors influencing distant metastasis in pediatric PTC.MethodsA total of 102,981 PTC patients were recruited from SEER registry, 2004-2015. Proportion of distant metastasis between children (≤18 years) and adults with different histopathological subtypes was compared by propensity score matching. The cut-off age for distant metastasis in children was calculated by receiver operating characteristic (ROC) curve, and the risk factors for distant metastasis in pediatric patients were analyzed by logistic regression models.ResultsAmong the 1,484 children and 101,497 adults included in the study, the incidence of CPTC patients with distant metastasis in children was higher than that in adults (p<0.001). The ROC curve was calculated, which yielded a cut-off age for distant metastasis in CPTC children as 16 years old. In CPTC, the proportion of young children (2-16 years) with distant metastasis was higher than that of adolescents (17-18 years) and adults (>18 years) (both p<0.001). While there was no such trend in FVPTC. In young children (2-16 years), the incidence of CPTC with distant metastasis was higher than FVPTC (p=0.006). There was no difference between the proportion of CPTC and FVPTC with distant metastasis in adolescents (17-18 years) and adults. Logistic regression models revealed that extrathyroidal extension, lymph node metastasis and CPTC histopathological subtype were risk factors for distant metastasis in young children aged 2 -16 years.ConclusionsIn CPTC, the incidence of distant metastasis in young children (2-16 years) was significantly higher than that in adolescents (17-18 years) and adults (>18 years). In patients with distant metastasis aged 2-16 years, the proportion of CPTC was higer than that of FVPTC. Extrathyroidal extension, lymph node metastasis, and CPTC histopathological subtype were risk factors for distant metastasis in young children aged 2-16 years.

scholarly journals The influence of extrathyroidal extension in development of metastasis in papillary thyroid cancer

2020 ◽  
Vol 13 (4) ◽  
pp. 183-191
Author(s):  
Vladimir A. Solodkiy ◽  
Dmitry K. Fomin ◽  
Dmitry A. Galushko ◽  
Hayk G. Asmaryan
Keyword(s):  
Thyroid Cancer ◽  
Lymph Node ◽  
Distant Metastasis ◽  
Radioiodine Therapy ◽  
Central Neck Dissection ◽  
Extrathyroidal Extension ◽  
Central Neck ◽  
Papillary Thyroid ◽  
Node Metastasis ◽  
Thyroid Capsule

Background: Papillary thyroid cancer (PTC) course and outcome very much depend on prognosis factors. One of the most significant factors is extrathyroidal extension (ETE), which can be local or extensive. In the view of some authors, tumor grow beyond the thyroid capsule is associated with high risk locoregional and distant metastasis, which increase disease recurrence and reduce survival. Some others do not see influence of minimal ETE on disease prognosis, so we need more trials to clarify the role of ETE in PTC. Aims: To evaluate the ETE role in development of metastasis in PTC patients. Materials and methods: The study includes 233 patients with PTC who receive treatment in RSCRR. 185 patients had clinical N0 stage, 48 patients were with verified N1a1b. All patients with cN0 underwent thyroidectomy with central neck dissection, patients with N1 thyroidectomy combined with different neck dissections, also superior mediastinal lymphadenectomy if required. Within combination treatment the radioiodine therapy was carried out. The histology evaluated thyroid capsule involvement and lymph node metastasis. Data processing was carried out in a Microsoft Access database, a one-factor dispersion analysis was used for the analysis of the quantitative signs, and a -square criterion was used for qualitative ones. Multifactor analysis was done in SPSS20 program. Results: Thyroid capsule extension was detected in 111 cases (47.6%), from which 92 were microscopic. 122 patients did not have ETE. The frequency of lymph node metastasis with or without ETE was 62.2% and35.8% respectively, which is significantly more often (р = 0.000, 2 = 21.342). In microscopic and macroscopic extension regional metastasis were 56.5% and 94.7%, distant metastasis 1.1 and 21% respectively. Statistically significant, the ETE was more prevalent in non-encapsulated tumor cases (р = 0.000, 2=15.122), and if the tumor size was more than 1cm (р = 0.026, 2 = 7.293). Only 41% of patients with cN0 had ETE, and patients with N1 72.9%, which is statistically significant (р = 0.000, 2 = 14.235). Conclusion: ETE is a predictor of PTC metastasis. The presence of ETE requires the necessity to apply the more aggressive treatment of PTC including thyroidectomy with central neck dissection and radioiodine therapy. Gross ETE significantly increases the risk of regional together with distant metastasis.

scholarly journals Risk Factors for Cervical Lymph Node Metastasis of Papillary Thyroid Microcarcinoma: A Single-Center Retrospective Study

2019 ◽  
Vol 2019 ◽  
pp. 1-6 ◽  
Author(s):  
Feng Cheng ◽  
Yanyan Chen ◽  
Lei Zhu ◽  
Bin Zhou ◽  
Yonghong Xu ◽  
...  
Keyword(s):  
Risk Factors ◽  
Lymph Node ◽  
Lymph Node Metastasis ◽  
Multivariate Logistic Regression Analysis ◽  
Extrathyroidal Extension ◽  
Papillary Thyroid Microcarcinoma ◽  
Papillary Thyroid ◽  
Node Metastasis ◽  
Thyroid Microcarcinoma ◽  
Independent Risk Factors

Objective. To identify the clinicopathological features correlated to lymph node metastasis (LNM) in patients with papillary thyroid microcarcinoma (PTMC). Methods. Clinical data of 785 PTMC patients who underwent surgical treatment at the Lishui Municipal Central Hospital from September 2008 to December 2017 were retrospectively analyzed. Clinical and pathological risk factors for lymph node metastasis (LNM), central lymph node metastasis (CLNM), and lateral lymph node metastasis (LLNM) were analyzed. Results. LNM was found in 236 (30.2%) patients. Multivariate logistic regression analysis revealed that in PTMC, male gender, age<55 years, tumor size>5 mm, bilateral lesions, and extrathyroidal extension were independent risk factors for LNM in general and for CLNM. For LLNM, tumor size>5 mm, multifocal lesions, and extrathyroidal extension were independent risk factors. Conclusions. Identification of risk factors for cervical LNM could assist individualization of clinical management for PTMC.

scholarly journals Clinical Heterogeneity of Differentiated Thyroid Cancer between Children Less than 10 Years of Age and Those Older than 10 Years: A Retrospective Study of 70 Cases

2021 ◽  
pp. 1-8
Author(s):  
Yuwei Liu ◽  
Shengcai Wang ◽  
Yanzhen Li ◽  
Xuexi Zhang ◽  
Zhiyong Liu ◽  
...  
Keyword(s):  
Risk Factors ◽  
Thyroid Cancer ◽  
Lymph Node ◽  
Retrospective Study ◽  
Lymph Node Metastasis ◽  
Distant Metastasis ◽  
Differentiated Thyroid Cancer ◽  
Age Groups ◽  
Clinical Heterogeneity ◽  
Node Metastasis

<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.

scholarly journals Extranodal Extension Is an Independent Prognostic Factor in Papillary Thyroid Cancer: A Propensity Score Matching Analysis

2021 ◽  
Vol 12 ◽  
Author(s):  
Tian-han Zhou ◽  
Bei Lin ◽  
Fan Wu ◽  
Kai-ning Lu ◽  
Lin-lin Mao ◽  
...  
Keyword(s):  
Risk Factors ◽  
Thyroid Cancer ◽  
Prognostic Factor ◽  
Propensity Score ◽  
Tumor Size ◽  
Cox Regression ◽  
Extrathyroidal Extension ◽  
Papillary Thyroid ◽  
Extranodal Extension ◽  
Independent Risk Factors

PurposeTo investigate the prognostic significance of extranodal extension (ENE) in papillary thyroid cancer (PTC).MethodsSeven hundred forty-three PTC patients were enrolled in the study from January 2014 to December 2017. The patients were dichotomized according to the presence of ENE. Logistic analysis was used to compare differences between the two groups. Kaplan–Meier (K-M) curve and propensity score matching (PSM) analyses were used for recurrence-free survival (RFS) comparisons. Cox regression was performed to analyze the effects of ENE on RFS in PTC.ResultsThirty-four patients (4.58%) had ENE. Univariate analysis showed that age, tumor size, extrathyroidal extension, and nodal stage were associated with ENE. Further logistic regression analysis showed that age, extrathyroidal extension, and nodal stage remained statistically significant. Evaluation of K-M curves showed a statistically significant difference between the two groups before and after PSM. Cox regression showed that tumor size and ENE were independent risk factors for RFS.ConclusionsAge ≥55 years, extrathyroidal extension, and lateral cervical lymph node metastasis were identified as independent risk factors for ENE. ENE is an independent prognostic factor in PTC.

scholarly journals Risk Patterns of Distant Metastases in Follicular, Papillary and Medullary Thyroid Cancer

2021 ◽  
Author(s):  
Andreas Machens ◽  
Kerstin Lorenz ◽  
Frank Weber ◽  
Henning Dralle
Keyword(s):  
Thyroid Cancer ◽  
Papillary Thyroid Cancer ◽  
Distant Metastasis ◽  
Medullary Thyroid Cancer ◽  
Papillary Thyroid ◽  
Follicular Thyroid Cancer ◽  
Follicular Variant ◽  
Node Negative ◽  
Medullary Thyroid ◽  
Node Metastasis

AbstractThis study of 542 patients with follicular thyroid cancer, 366 patients with the follicular variant and 1452 patients with the classical variant of papillary thyroid cancer, and 819 patients with sporadic medullary thyroid cancer operated at a tertiary referral center aimed to determine risk patterns of distant metastasis for each tumor entity, which are ill-defined. On multivariable logistic regression analyses, lymph node metastasis consistently emerged as an independent risk factor of distant metastasis, yielding odds ratios (ORs) of 2.4 and 2.8 for follicular thyroid cancer and the follicular variant of papillary thyroid cancer, and ORs of 5.9 and 6.4 for the classical variant of papillary thyroid cancer and sporadic medullary thyroid cancer. Another independent risk factor consistently associated with distant metastasis, most strongly in follicular thyroid cancer and the follicular variant of papillary thyroid cancer (OR 3.5 and 4.0), was patient age >60 years. Altogether, 2 distinct risk patterns of distant metastasis were identified, which were modulated by other cancer type-dependent risk factors: one with lymph node metastasis as leading component (classical variant of papillary thyroid cancer and sporadic medullary thyroid cancer), and another one with age as leading component (follicular thyroid cancer and the follicular variant of papillary thyroid cancer). Distant metastasis was exceptional in node-negative patients with sporadic medullary thyroid cancer (1.7%) and the classical variant of papillary thyroid cancer (1.4%), and infrequent in node-negative patients with the follicular variant of papillary thyroid cancer (4.4%). These findings delineate windows of opportunity for early surgical intervention before distant metastasis has occurred.

scholarly journals Risk Factors for Recurrent Papillary Thyroid Carcinoma

2018 ◽  
Vol 32 (2) ◽  
pp. 25-29
Author(s):  
Jonel Donn Leo S. Gloria ◽  
Alfredo Quintin Y. Pontejos ◽  
Precious Eunice R. Grullo
Keyword(s):  
Risk Factors ◽  
Thyroid Cancer ◽  
Papillary Thyroid Carcinoma ◽  
Thyroid Carcinoma ◽  
Papillary Thyroid Cancer ◽  
Tumor Size ◽  
Univariate Analysis ◽  
Extrathyroidal Extension ◽  
Papillary Thyroid ◽  
Clinicopathologic Factor

Objective:  To identify risk factors associated with disease recurrence among Filipinos with papillary thyroid carcinoma (PTC). Methods: Design:           Retrospective cohort study Setting:           Tertiary National University Hospital Participants: 76 patients diagnosed with papillary thyroid carcinoma, classified as low and low-to-intermediate risk (2015 ATA classification) that underwent total thyroidectomy with or without neck dissection from 2010-2014 and were followed up from 10 months to 5 years. Log rank and Cox regression analyses were used to determine significant risk factors for recurrence. Results:  29 (38.15%) had recurrence.  On univariate analysis, age, tumor size, multifocality, extrathyroidal extension, presence of lateral neck nodes and RAI therapy were statistically associated with recurrence.  However, on multivariate analysis, no clinicopathologic factor was statistically associated with recurrence. Conclusion: Age of >45 years, female sex, tumor size of >2 cm, multifocality, presence of microscopic extrathyroidal extension, and lymph node metastasis might contribute to the recurrence of papillary thyroid cancer while post-operative radioactive ablation may have some protective effect.  However, this study suggests that other factors must be included in the model to better understand the relationship between these factors and recurrence.   Keywords: papillary thyroid cancer, thyroid neoplasm, recurrence

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