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Risk and Survival of Patients with Undifferentiated Thyroid Cancer: National Perspective
Abstract   Open access   Peer reviewed

Risk and Survival of Patients with Undifferentiated Thyroid Cancer: National Perspective

Helmi Khadra, Zaid Al-Qurayshi and Emad Kandil
Journal of the American College of Surgeons, Vol.225(4), pp.S73-S74
10/2017
DOI: 10.1016/j.jamcollsurg.2017.07.154
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https://doi.org/10.1016/j.jamcollsurg.2017.07.154View
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Abstract

Endocrine surgery Risk and Survival of Patients with Undifferentiated Thyroid Cancer: National Perspective Khadra, Helmi MD; Al-Qurayshi, Zaid MD, MPH; Kandil, Emad MBBCh, FACS Author Information Journal of the American College of Surgeons 225(4):p S73-S74, October 2017. | DOI: 10.1016/j.jamcollsurg.2017.07.154 INTRODUCTION: Undifferentiated thyroid cancer is recognized for its low incidence and grievous prognosis. In this study, we aimed to examine the characteristics of patients with undifferentiated thyroid cancer and their overall survival. METHODS: We performed a retrospective cohort study using the National Cancer Database, 2004 to 2012. The study population included adults (≥18 years) with either undifferentiated thyroid cancer (UTC) (cases) or with differentiated thyroid cancer (DTC) (controls). RESULTS: A total of 1,551 UTC and 166,170 DTC patients were included. The median follow-up time for UTC was 3.8 months (interquartile range [IQR] 1.6–8.8); for DTC it was 51.9 months (IQR 29.3–76.8). As compared to DTC, patients with UTC were more likely to be ≥45 years old, male, and black (p < 0.01 each). Additionally UTC was more likely to be diagnosed in low-volume hospitals (p < 0.01). In patients with UTC and without distant metastasis, survival was worse for those on Medicaid (hazard ratio [HR] 1.48, 95% CI 1.001, 2.19, p = 0.049) or Medicare (HR 1.31, 95% CI 1.04, 1.66, p = 0.024) as compared to patients with private insurance. In patients with distant metastasis, insurance type did not affect survival. Regardless of distant metastasis status, patients who underwent thyroid surgery, radiotherapy, or chemotherapy had an improved survival in the adjusted model (p < 0.05 each). CONCLUSIONS: Older age, male, and black race are associated with a higher risk of UTC. UTC appears to be diagnosed in patients who cannot afford to be treated in an advanced center. Insurance type affects survival of patients with UTC without distant metastasis.

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