Risk factor analysis in differentiated thyroid cancer

Cady, Blake; Sedgwick, Cornelius E.; Meissner, William A.; Wool, Marvin S.; Salzman, Ferdinand A.; Werber, Joan

doi:10.1002/1097-0142(197903)43:3<810::aid-cncr2820430306>3.0.co;2-b

Cited by 290 publications

(140 citation statements)

References 12 publications

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“…Results from the Cox proportional hazards regression models identified and verified a series of risk predictors for mortality in DTC, including sex, age, and advanced stage, which were consistent with previous studies 19, 20. Then, we conducted subgroup analysis for the effects of marital status on survival in patients stratified by them.…”

Section: Resultssupporting

confidence: 83%

The impact of marital status at diagnosis on cancer survival in patients with differentiated thyroid cancer

Shi

Lü

et al. 2016

Cancer Medicine

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Previous studies have revealed that marital status influences the prognosis of patients with various types of cancer. We evaluated the influence of marriage on the survival outcomes in differentiated thyroid cancer (DTC). The Surveillance, Epidemiology and End Results (SEER) database between 2002 and 2012 was used to compare cancer‐specific mortality in different marital status, and in each sex, age, and stage stratification by multivariate Cox regression model. In total, 61,077 eligible patients were identified. The widowed group had the highest proportion of women, elderly patients (≥45 years), and advanced stage III/IV tumor (P = 0.001), but the total thyroidectomy (TT) performed and radioisotopes therapy rates were lower than those in the married group. Married patients had a better cancer‐specific survival (CSS) than the unmarried (P < 0.05). Further analysis showed that widowed patients always presented the lowest CSS compared with other groups. Widowed patients had a significant increased risk for CSS compared with married patients in males [hazard ratio (HR) 2.72, 95% confidence interval (CI): 1.59–4.65, P = 0.001], females (HR 2.02, 95% CI: 2.24–4.06, P = 0.001), young patients (<45, HR 28.12, 95% CI: 3.48–227.25, P = 0.002), elderly patients (≥45, HR 28.12, 95% CI: 2.97, 95% CI: 2.30–3.83, P = 0.001), stage I (HR 8.44, 95% CI: 4.05–17.59, P = 0.001), stage II (HR 3.64, 95% CI: 1.30–10.20, P = 0.014), stage III (HR 2.27, 95% CI: 1.08–4.78, P = 0.031), and stage IV (HR 2.63, 95% CI: 1.94–3.57, P = 0.001). These results showed that unmarried status, especially for widowhood, increased the risk of cancer mortality in DTC patients.

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Section: Resultssupporting

confidence: 83%

The impact of marital status at diagnosis on cancer survival in patients with differentiated thyroid cancer

Shi

Lü

et al. 2016

Cancer Medicine

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“…The first report from the Lahey Clinic Foundation (Cady et al 1979) used three prognostic factors for the analysis of risk in cases of DTC, namely age (cut-off 40 years for men and 50 years for women), gender and histological type: follicular vs papillary. Applying the same prognostic factors as stated in the first publication of the AMES Table 2 Characteristics of the population in terms of the recurrence (REC) of differentiated thyroid carcinoma and overall survival (OS).…”

Section: The Ames Classificationcontrasting

confidence: 58%

“…Age at the time of diagnosis, gender, histological type, tumour size and extrathyroidal invasion have been found previously to be associated with a poor clinical outcome (Cady & Rossi 1988, De Groot et al 1990, Hay 1990, Schlumberger & Pacini 1999, while the prognostic impact of regional lymph node metasases is still a controversial issue (Cady & Rossi 1988, De Groot et al 1990, Frankenthaler et al 1990, Akslen et al 1991, Sellers et al 1992. The presence of distant metastases at the time of diagnosis is a recognised factor for a poor prognosis (Cady et al 1979, Hay 1990.…”

Section: Introductionmentioning

confidence: 99%

Prognostic factors in differentiated thyroid carcinomas and their implications for current staging classifications

Jukkola¹,

Bloigu²,

Ebeling³

et al. 2004

Endocr Relat Cancer

129

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Differentiated thyroid carcinomas (DTC) (papillary, follicular and follicular type of papillary) have a favourable prognosis, but a proportion of patients develop recurrences and eventually die of the disease. Various prognostic factors have been identified and been used to create the current staging classifications (AGES, AMES, MACIS, EORTC, UICC-TNM). We examined 499 DTC patients retrospectively to validate known prognostic factors that enable them to be recognised as having either a low or a high risk of death related to a recurrence of DTC, by reference to the current staging classifications. Sixty-nine of them (14%) had local or distant recurrences, the mean time to recurrence being 7.7 years. The 10-year disease-free survival rate was 80%, and the ten-year overall survival rate for the entire group was 91%, with a mean survival time of 8.7 years. Male gender, a follicular type of tumour, larger tumour size, extrathyroidal invasion outside the capsule and nodal metastases were all related to a higher incidence of tumour recurrence, and the follicular type of histology, age > 45 years, larger tumour size and local invasion entailed poorer survival. The AMES and to some extent the EORTC classification were not reproducible in this material, mainly because some prognostic variants were no longer encountered or were insufficient in number to allow reliable conclusions to be drawn. The MACIS staging classification leaves the definition of the intermediate and high risk groups too wide and is therefore not very reliable. Pooling of stages I and II improved the relevance of the TNM classification. All the current staging classifications are able to discern a low risk DTC group well. We achieved a highly accurate definition of risk in the present material using only two parameters, age (cut-off value 50 years) and extracapsular invasion of the thyroid gland.

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“…Some investigators have reported that the age of the patient is an important prognostic factor in papillary and follicular carcinomas (Crile and Hazard, 1953;Cady et al, 1979), whereas others (Franssila, 1975;Byar et al, 1979;Hay et al, 1993) have great emphasis on age, sex and tumour status in the scoring system. Shi and Farid (1993) reported a negative correlation between expression of TSH-R mRNA and tumour stage in most patients.…”

Section: Resultsmentioning

confidence: 99%

Relationship between prognostic score and thyrotropin receptor (TSH-R) in papillary thyroid carcinoma: immunohistochemical detection of TSH-R

Tanaka

Inoue²,

Miki³

et al. 1997

Br J Cancer

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Summary We have demonstrated the expression of thyrotropin receptor (TSH-R) in thyroid neoplasms (13 adenomas, 21 papillary carcinomas, two follicular carcinomas) and adjacent normal thyroid using the monoclonal antibody against human TSH-R and have also demonstrated a relationship between prognostic scores and the expression of TSH-R. Among the adenomas, eight showed an intensity similar to that of normal thyroid and five showed a higher intensity than normal. Two tumours exhibited heterogeneous distribution of TSH-R. Among the papillary carcinomas, seven showed similar intensity to normal tissue and four showed higher intensity and ten showed weaker intensity. Eight tumours showed heterogeneous distribution of the stain. Among the follicular carcinomas, one showed similar intensity to normal tissue and the other exhibited weaker intensity. Both cases showed homogeneous distribution of TSH-R. The adenomas never showed a weaker intensity than normal thyroid, but various intensities of TSH-R occurred in differentiated carcinomas. There was no significant relationship between the clinical data and the signal intensity in the adenomas. Among the papillary carcinomas, however, the group with weaker intensity had significantly poorer prognostic scores than the other two groups. Thus, we assume that low TSH-R may be expressed by the clinically high-rsk group of patients with papillary thyroid carcinoma.

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Risk factor analysis in differentiated thyroid cancer

Cited by 290 publications

References 12 publications

The impact of marital status at diagnosis on cancer survival in patients with differentiated thyroid cancer

The impact of marital status at diagnosis on cancer survival in patients with differentiated thyroid cancer

Prognostic factors in differentiated thyroid carcinomas and their implications for current staging classifications

Relationship between prognostic score and thyrotropin receptor (TSH-R) in papillary thyroid carcinoma: immunohistochemical detection of TSH-R

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