Abstract
Minimal Invasion, Nodal Metastasis, and Tumor Size Impact on Survival of Patients with Stage III Papillary Thyroid Cancer
Journal of the American College of Surgeons, Vol.223(4), pp.S141-S141
10/2016
DOI: 10.1016/j.jamcollsurg.2016.06.300
Abstract
Introduction
Differentiated thyroid cancer with minimal extrathyroidal extension (MEE), or metastasis to level VI lymph nodes is classified as stage III regardless of the tumor size. In this study, we aimed to examine the effect of tumor size on the overall survival and management of this particular population.
Methods
A retrospective cohort study was performed using the National Cancer Data Base, 2004 to 2012. The study population included patients ≥45 years old, who underwent thyroid surgery for a papillary thyroid cancer (PTC) (pT1-3M0) with either (N1a) or MEE, compared with patients with stage II.
Results
A total of 4,170 patients with (N1a) and no MEE; and 3,569 patients with N0 and MEE were included and compared to 4,099 patients with stage II PTC. Median follow-up time was 47.9 months (interquartile range 28.5–72.9 months). Patients with (N1a), no MEE, and tumor size ≤4 cm had no significant survival difference compared with patients with stage II in the adjusted model (hazard ratio [HR] 1.03, 95% CI [0.80-1.31], p=0.83), while their counterparts with tumor size >4 cm had significantly lower survival (HR 2.34, 95% CI [1.46-3.76], p<0.001). Patients with N0, MEE, and tumor size ≤4 cm had no significant survival difference compared with patients with stage II (HR 0.92, 95% CI [0.71-1.17], p=0.48), while their counterparts with tumor size >4 cm had significantly lower survival (HR 2.29, 95% CI [1.61-3.24], p<0.001).
Conclusions
Patients with PTC and N1a or MEE and tumor size <4 cm, have similar survival to patients with stage II. Our data support re-evaluation of the current staging system.
Details
- Title: Subtitle
- Minimal Invasion, Nodal Metastasis, and Tumor Size Impact on Survival of Patients with Stage III Papillary Thyroid Cancer
- Creators
- Zaid Al-QurayshiSudesh K. Srivastav - Tulane UniversityEmad Kandil - Tulane University
- Resource Type
- Abstract
- Publication Details
- Journal of the American College of Surgeons, Vol.223(4), pp.S141-S141
- DOI
- 10.1016/j.jamcollsurg.2016.06.300
- ISSN
- 1072-7515
- eISSN
- 1879-1190
- Language
- English
- Date published
- 10/2016
- Academic Unit
- Otolaryngology
- Record Identifier
- 9984702901402771
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