The Prognosis of Papillary Thyroid Cancer with Initial Distant Metastasis is Strongly Associated with Extensive Extrathyroidal Extension : A Retrospective Cohort Study
BACKGROUND: Extensive extrathyroidal extension (ETE) has a significant role in the prognosis of papillary thyroid cancer (PTC) without distant metastasis, but its role in PTC with initial distant metastasis has never been studied. This study aimed to evaluate the prognostic significance of extensive ETE regarding disease progression, survival, and remission in PTC patients with initial distant metastasis.
METHODS: This retrospective cohort study included PTC patients with initial distant metastasis who underwent total thyroidectomy with a median follow-up period of 6.7 years. The prognostic significance of extensive ETE was assessed in terms of time to tumor progression (TTP), cancer-specific survival (CSS), and cumulative incidence of remission with all-cause death as the competing event.
RESULTS: The study enrolled 64 patients. Of these patients, 21 (32.8%) had extensive ETE, which was associated with a shorter TTP (adjusted hazard ratio [HR], 4.10; p = 0.015) and a lower CSS rate (p = 0.002, log-rank), particularly for patients 55 years of age or older with stage 4b disease (10-year CSS rate: 33.3% in those with and 92.3% in those without extensive ETE; p = 0.017). Additionally, remission was observed only in patients without extensive ETE (10-year cumulative incidence of remission: 0.0% in those with and 29.3% in those without extensive ETE; p = 0.013).
CONCLUSIONS: Extensive ETE of the primary lesion results in poorer prognoses for PTC patients with initial distant metastasis. The high CSS rate for patients with stage 4b PTC but no extensive ETE indicates that the prognosis of this patient population should be distinguished from that of other stage 4 cases.
Medienart: |
E-Artikel |
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Erscheinungsjahr: |
2019 |
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Erschienen: |
2019 |
Enthalten in: |
Zur Gesamtaufnahme - volume:26 |
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Enthalten in: |
Annals of surgical oncology - 26(2019), 7 vom: 20. Juli, Seite 2200-2209 |
Sprache: |
Englisch |
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Beteiligte Personen: |
Lee, Young Ki [VerfasserIn] |
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Anmerkungen: |
Date Completed 13.12.2019 Date Revised 17.12.2019 published: Print-Electronic Citation Status MEDLINE |
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doi: |
10.1245/s10434-019-07314-x |
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funding: |
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Förderinstitution / Projekttitel: |
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PPN (Katalog-ID): |
NLM295181966 |
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245 | 1 | 4 | |a The Prognosis of Papillary Thyroid Cancer with Initial Distant Metastasis is Strongly Associated with Extensive Extrathyroidal Extension |b A Retrospective Cohort Study |
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520 | |a BACKGROUND: Extensive extrathyroidal extension (ETE) has a significant role in the prognosis of papillary thyroid cancer (PTC) without distant metastasis, but its role in PTC with initial distant metastasis has never been studied. This study aimed to evaluate the prognostic significance of extensive ETE regarding disease progression, survival, and remission in PTC patients with initial distant metastasis | ||
520 | |a METHODS: This retrospective cohort study included PTC patients with initial distant metastasis who underwent total thyroidectomy with a median follow-up period of 6.7 years. The prognostic significance of extensive ETE was assessed in terms of time to tumor progression (TTP), cancer-specific survival (CSS), and cumulative incidence of remission with all-cause death as the competing event | ||
520 | |a RESULTS: The study enrolled 64 patients. Of these patients, 21 (32.8%) had extensive ETE, which was associated with a shorter TTP (adjusted hazard ratio [HR], 4.10; p = 0.015) and a lower CSS rate (p = 0.002, log-rank), particularly for patients 55 years of age or older with stage 4b disease (10-year CSS rate: 33.3% in those with and 92.3% in those without extensive ETE; p = 0.017). Additionally, remission was observed only in patients without extensive ETE (10-year cumulative incidence of remission: 0.0% in those with and 29.3% in those without extensive ETE; p = 0.013) | ||
520 | |a CONCLUSIONS: Extensive ETE of the primary lesion results in poorer prognoses for PTC patients with initial distant metastasis. The high CSS rate for patients with stage 4b PTC but no extensive ETE indicates that the prognosis of this patient population should be distinguished from that of other stage 4 cases | ||
650 | 4 | |a Journal Article | |
700 | 1 | |a Kim, Daham |e verfasserin |4 aut | |
700 | 1 | |a Shin, Dong Yeob |e verfasserin |4 aut | |
700 | 1 | |a Lee, Cho Rok |e verfasserin |4 aut | |
700 | 1 | |a Lee, Eun Jig |e verfasserin |4 aut | |
700 | 1 | |a Kang, Sang-Wook |e verfasserin |4 aut | |
700 | 1 | |a Lee, Jandee |e verfasserin |4 aut | |
700 | 1 | |a Jeong, Jong Ju |e verfasserin |4 aut | |
700 | 1 | |a Nam, Kee-Hyun |e verfasserin |4 aut | |
700 | 1 | |a Chung, Woong Youn |e verfasserin |4 aut | |
700 | 1 | |a Park, Cheong Soo |e verfasserin |4 aut | |
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