Can Age at Diagnosis and Sex Improve the Performance of the American Thyroid Association Risk Stratification System for Prediction of Structural Persistent and Recurrent Disease in Patients With Differentiated Thyroid Carcinoma? A Multicenter Study

Zuhur, Sayid Shafi; Ağgül, Hünkar; Çelık, Mehmet; Avcı, Uğur; Erol, Selvinaz; Kılınç, Faruk; Akbaba, Gülhan; Çınar, Neşe; Tekin, Sakin; Şahin, Serdar; Bilen, Ogun; Elbüken, Gülşah; Güldiken, Sibel; Kadıoğlu, Pınar; Bayraktaroğlu, Taner; Topçu, Birol

doi:10.1016/j.eprac.2021.09.001

Cited by 8 publications

(4 citation statements)

References 30 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Recently, Zuhur et al. ( 17 ) confirmed the prognostic significance of male sex in differentiated thyroid carcinoma and reported that according to the American Thyroid Association low-risk category, male sex predicted a markedly shorter disease-free survival. The induction of worse biologic behaviors and prognosis of the male sex might have also partially contributed to our finding.…”

Section: Discussionmentioning

confidence: 98%

Predictors of Malignancy in Thyroid Nodules Classified as Bethesda Category III

Liu

Wang

et al. 2022

Front. Endocrinol.

View full text Add to dashboard Cite

ObjectiveTo determine predictors of malignancy in surgically treated Bethesda category III nodules.MethodsPatients with surgically treated thyroid nodules classified as Bethesda category III were retrospectively enrolled. The association between clinical/sonographic features and postoperative pathology was evaluated using univariate and multivariate analyses.ResultsA total of 188 nodules from 184 patients were included. The overall malignancy rate was 54.3%. In univariate analysis, male sex, aspect ratio >1, microcalcification, unclear boundary, BRAFV600E mutation, and nuclear atypia were significantly associated with malignant disease in Bethesda category III nodules. Multivariate analysis confirmed that male sex, aspect ratio >1, microcalcification, and BRAFV600E mutation were independent predictors of malignant disease.ConclusionsMalignant disease was common in Bethesda category III nodules, and surgical treatment was strongly indicated in the presence of male sex, aspect ratio>1, microcalcification, and BRAFV600E mutation.

show abstract

Section: Discussionmentioning

confidence: 98%

Predictors of Malignancy in Thyroid Nodules Classified as Bethesda Category III

Liu

Wang

et al. 2022

Front. Endocrinol.

View full text Add to dashboard Cite

show abstract

“…The treatment and follow-up protocols of the patients were carried out as previously reported [20]. All patients had undergone total thyroidectomy or hemithyroidectomy.…”

Section: Treatment and Follow-up For Clinical Outcomesmentioning

confidence: 99%

“…This study was performed in line with the principles of the Declaration of Helsinki. Approval was granted by the Ethics Committee of Tekirdag Namık Kemal University, School of Medicine.Treatment and Follow-up for Clinical Outcomes:The treatment and follow-up protocols of the patients were carried out as previously reported[20]. All patients had undergone total thyroidectomy or hemithyroidectomy.…”

mentioning

confidence: 99%

Do Histologically Aggressive Subtypes of Papillary Thyroid Microcarcinoma have Worse Clinical Outcome than Non-Aggressive Papillary Thyroid Microcarcinoma Subtypes? A Multicenter Cohort Study

et al. 2023

Self Cite

View full text Add to dashboard Cite

Histologically aggressive micropapillary thyroid carcinomas (PTMC) subtypes are thought to be associated with an aggressive clinical course. However, evidence for unfavorable clinical outcomes in patients with aggressive PTMC subtypes is not clear. In this study, we intended to determine the difference in clinical outcomes between patients with aggressive and non-aggressive PTMC subtypes. In this multicenter cohort study, the computer-recorded clinical and histopathological data of patients who underwent thyroid surgery between January 2000 - January 2021 in 9 referral centers and were diagnosed as PTMC were analyzed. A total of 1585 patients [female 1340 (84.5%), male 245 (15.5%), mean age 47.9±11.63 years), with a mean follow-up time of 66.55±37.16 months], were included in the study. Ninety-eight cases were diagnosed as aggressive and 1487 as non-aggressive subtypes. Persistent/recurrent disease was observed in 33 (33.7% )and 41(2.8%) patients with aggressive and non-aggressive subtypes (p <0.001). Diseases-free survival rates were markedly lower in patients with aggressive than in those with non-aggressive PTMC subtypes (66.3% vs 94.8%, Log-rank p <0.001). Moreover, in multivariate analysis, aggressive histology was an independent predictor of persistent/recurrent disease, after controlling for other contributing factors (HR 5.78, 95% CI 3,32-10, p <0,001). Patients with aggressive PTMC subtypes had higher rates of incomplete biochemical and structural response than patients with non-aggressive subtypes as well (p <0.001). Aggressive PTMC subtypes share many characteristics with histologically identical tumors >1 cm in size. Therefore, the histopathological subtype of PTMC should be taken into consideration to tailor a personalized management plan.

show abstract

“…Among others, age should be discussed as a further risk factor, which is an important point for the classification of prognostic stage groups according to the American Joint Committee on Cancer (AJCC) / Union Internationale Contre le Cancer (UICC) (34). Zuhur et al could show, that an age cutoff of 45 years may identify patients at a higher risk of persistence/recurrence in the ATA lowand intermediate-risk categories; besides disease-free survival was longer in females in the ATA low-risk category (35). Thus, sex is also a possible influencing factor.…”

Section: Other Risk Factorsmentioning

confidence: 99%

Shared Decision Making for Radioiodine Therapy and the Actual Pattern of Care in Intermediate-Risk Differentiated Thyroid Carcinoma

2022

View full text Add to dashboard Cite

Radioiodine therapy (RAI) is usually a standard procedure performed after thyroidectomy in differentiated thyroid cancer (DTC). While the indication for RAI in high-risk patients has been established in various national and international guidelines, there is an ongoing discussion with regard to intermediate-risk patients. In addition to the inconsistent definition of this risk category, the absence of large multinational prospective randomized controlled trials forms the basis of the debate. In this context, the actual pattern of care and national guidelines in the country where the patient is living plays an important role with respect to regional iodine supply and goiter prevalence, preoperative diagnostics (fine needle aspiration biopsy), and corresponding surgical strategies. Participatory decision-making between physician and informed patient, which is demanded in principle today anyway, is of particular importance in this situation. This article will discuss the approach of shared decision making for radioiodine therapy in intermediate-risk DTC.

show abstract

Can Age at Diagnosis and Sex Improve the Performance of the American Thyroid Association Risk Stratification System for Prediction of Structural Persistent and Recurrent Disease in Patients With Differentiated Thyroid Carcinoma? A Multicenter Study

Cited by 8 publications

References 30 publications

Predictors of Malignancy in Thyroid Nodules Classified as Bethesda Category III

Predictors of Malignancy in Thyroid Nodules Classified as Bethesda Category III

Do Histologically Aggressive Subtypes of Papillary Thyroid Microcarcinoma have Worse Clinical Outcome than Non-Aggressive Papillary Thyroid Microcarcinoma Subtypes? A Multicenter Cohort Study

Shared Decision Making for Radioiodine Therapy and the Actual Pattern of Care in Intermediate-Risk Differentiated Thyroid Carcinoma

Contact Info

Product

Resources

About