Some Possible Confounders in Study of Patient Age and Progression of Low-risk Papillary Thyroid Carcinoma

Some Possible Confounders in Study of Patient Age and Progression of Low-risk Papillary Thyroid Carcinoma—Reply

“…We agree that it will be important to examine if there is any association of TSH or thyroid hormone treatment with PTC active surveillance outcomes in future research. We conclude by thanking Chang et al 2…”

“…Furthermore, according to current clinical guidelines, thyroidectomy or lobectomy should be administered as first-line treatment for patients with tumors over 1 cm in maximal diameter. 2 In this meta-analysis, 2 studies included patients with tumors up to 2 cm in maximal diameter, who received active surveillance instead of surgery. 1 These events are inconsistent with routine clinical practice, thus tumor progression in these individuals is more intriguing.…”

“…Chang et al have also suggested analyzing the effect of thyroid-stimulating hormone (TSH) levels on outcomes. 2 In our data abstraction form, we sought to abstract data on mean TSH, but this was not reported in the included studies and could not be analyzed. We agree that it will be important to examine if there is any association of TSH or thyroid hormone treatment with PTC active surveillance outcomes in future research.…”

“…In Reply We recently published a systematic review and meta-analysis examining the relationship between age and papillary thyroid cancer (PTC) progression risk under active surveillance . We greatly appreciate the interest and thoughtful review of the article reported in the Letter to the Editor and in the Commentary by Chang et al In response, we are happy to elaborate on our research and discuss the proposed suggestions for secondary analyses.…”

“…Chang et al suggested that “patients older than 50 or 60 years accounted for a large portion of participants” and that “they should also be included in the analysis” and that “exclusion of patients older than 50 or 60 years might suggest bias in patient inclusion and could be a threat to the validity of the results of the meta-analyses.” We agree that individuals older than 50 or 60 years should be included in the meta-analyses and that is why we did not exclude them, but compared them with younger patients. We would like to clarify that the older group in our study included individuals aged 40 to 50 years or older.…”